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Urination - difficulty with flow

Delayed urination; Hesitancy; Difficulty initiating urination

Difficulty starting or maintaining a urine stream is called urinary hesitancy.

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Female urinary tract
Male urinary tract

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Considerations

Urinary hesitancy affects people of all ages and occurs in both sexes. However, it is most common in older men with an enlarged prostate gland.

Urinary hesitancy most often develops slowly over time. You may not notice it until you are unable to urinate (called urinary retention). This causes swelling and discomfort in your bladder.

Causes

The most common cause of urinary hesitancy in older men is an enlarged prostate. Almost all older men have some trouble with dribbling, weak urine stream, and starting urination.

Another common cause is infection of the prostate or urinary tract. Symptoms of a possible infection include:

The problem can also be caused by:

Home Care

Steps you can take to care for yourself include:

When to Contact a Medical Professional

Call your provider if you notice urinary hesitancy, dribbling, or a weak urine stream.

Call your provider right away if:

What to Expect at Your Office Visit

Your provider will take your medical history and do an exam to look at your pelvis, genitals, rectum, abdomen, and lower back.

You may be asked questions such as:

Tests that may be performed include:

Treatment for urinary hesitancy depends on the cause, and may include:

References

Elsamra SE. Evaluation of the urologic patient: history and physical examination. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 1.

Smith PP, Kuchel GA. Aging of the urinary tract. In: Fillit HM, Rockwood K, Young J, eds. Brocklehurst's Textbook of Geriatric Medicine and Gerontology. 8th ed. Philadelphia, PA: Elsevier, 2017:chap 22.

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Review Date: 7/26/2021  

Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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