Urinary hesitancy (patient information)

For doctor information click here

WikiDoc Resources for Urinary hesitancy (patient information)

Articles

Most recent articles on Urinary hesitancy (patient information)

Most cited articles on Urinary hesitancy (patient information)

Review articles on Urinary hesitancy (patient information)

Articles on Urinary hesitancy (patient information) in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Urinary hesitancy (patient information)

Images of Urinary hesitancy (patient information)

Photos of Urinary hesitancy (patient information)

Podcasts & MP3s on Urinary hesitancy (patient information)

Videos on Urinary hesitancy (patient information)

Evidence Based Medicine

Cochrane Collaboration on Urinary hesitancy (patient information)

Bandolier on Urinary hesitancy (patient information)

TRIP on Urinary hesitancy (patient information)

Clinical Trials

Ongoing Trials on Urinary hesitancy (patient information) at Clinical Trials.gov

Trial results on Urinary hesitancy (patient information)

Clinical Trials on Urinary hesitancy (patient information) at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Urinary hesitancy (patient information)

NICE Guidance on Urinary hesitancy (patient information)

NHS PRODIGY Guidance

FDA on Urinary hesitancy (patient information)

CDC on Urinary hesitancy (patient information)

Books

Books on Urinary hesitancy (patient information)

News

Urinary hesitancy (patient information) in the news

Be alerted to news on Urinary hesitancy (patient information)

News trends on Urinary hesitancy (patient information)

Commentary

Blogs on Urinary hesitancy (patient information)

Definitions

Definitions of Urinary hesitancy (patient information)

Patient Resources / Community

Patient resources on Urinary hesitancy (patient information)

Discussion groups on Urinary hesitancy (patient information)

Patient Handouts on Urinary hesitancy (patient information)

Directions to Hospitals Treating Urinary hesitancy (patient information)

Risk calculators and risk factors for Urinary hesitancy (patient information)

Healthcare Provider Resources

Symptoms of Urinary hesitancy (patient information)

Causes & Risk Factors for Urinary hesitancy (patient information)

Diagnostic studies for Urinary hesitancy (patient information)

Treatment of Urinary hesitancy (patient information)

Continuing Medical Education (CME)

CME Programs on Urinary hesitancy (patient information)

International

Urinary hesitancy (patient information) en Espanol

Urinary hesitancy (patient information) en Francais

Business

Urinary hesitancy (patient information) in the Marketplace

Patents on Urinary hesitancy (patient information)

Experimental / Informatics

List of terms related to Urinary hesitancy (patient information)

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

## Considerations

[edit | edit source]

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 usually comes on slowly over time. You may not notice it until you are unable to urinate (urinary retention), and your bladder swells and becomes uncomfortable.

Almost all older men have some trouble with:

* Dribbling
* Starting urination
* Weaker urine stream

## Causes

[edit | edit source]

Urinary hesitancy can be caused by:

* Drugs (some cold remedies, some nasal decongestants, tricyclic antidepressants, and anticholinergic drugs used for incontinence)
* Enlarged prostate (benign prostatic hyperplasia)
* Inflammation or infection of the prostate gland (prostatitis)
* Nervous system disorders
* Recent surgery (postoperative urinary retention)
* Scar tissue (stricture)
* Shy or bashful bladder syndrome (being unable to urinate when another person is in the room)
* Urinary tract infection

## Home Care

[edit | edit source]

* Monitor, record, and report your urination patterns to your doctor.
* Apply heat to your lower abdomen (below your belly button and above the pubic bone). This is where the bladder sits. The heat relaxes muscles and aids urination.
* Massage or place light pressure over your bladder to stimulate emptying.
* Drink plenty of fluids.
* For infections, you will need antibiotics from your doctor. Symptoms of a possible infection include burning or pain with urination, frequent urination, cloudy urine, and a sense of urgency (strong, sudden urge to urinate).
* Pay close attention to any medicines or supplements you take.

See also:

* Enlarged prostate - after care
* Prostatitis - bacterial - self-care

## When to Contact a Medical Professional

[edit | edit source]

Call your doctor for urinary hesitancy, dribbling, or a weak urine stream if you have not already been evaluated for these problems.

Call your doctor right away if:

* You have a fever, vomiting, side or back pain, shaking chills, or are passing little urine for 1 to 2 days
* You have blood in your urine, cloudy urine, a frequent or urgent need to urinate, or a discharge from the penis or vagina
* You are unable to pass urine

## What to Expect at Your Office Visit

[edit | edit source]

Your doctor will take your medical history and perform a physical examination, paying special attention to your pelvis, rectum, abdomen, and lower back.

Medical history questions may include:

* How long have you had difficulty starting your urine flow?
* Did it come on over time or suddenly?
* Is it worse in the morning or at night?
* Is the force of your urine flow decreased?
* Do you have dribbling?
* Do you ever leak urine uncontrollably?
* Does anything help? Like heat or massage to the lower abdomen?
* Does anything make the hesitancy worse?
* Do you have other symptoms like fever, pain or burning when you urinate, cloudy or bloody urine, back or side pain?
* Do you have a history of bladder or kidney infection? Prostate enlargement or infection? Nervous system disorders?
* Have you had a recent injury, surgery, or procedure on the pelvis or bladder?
* What medications do you take, including over-the-counter drugs?

## Tests that may be performed include

[edit | edit source]

* Catheterization of the bladder to determine residual urine volume and to get urine for culture (a catheterized urine specimen)
* Cystometrography
* Transrectal ultrasound of the prostate (similar to a transvaginal ultrasound)
* Urethral swab for culture
* Urinalysis and culture
* Voiding cystourethrogram

## Treatment

[edit | edit source]

Treatment for urinary hesitancy depends on the cause. Often, medications such as alpha-blockers can relieve the symptoms. If you have a bacterial infection, your health care provider may prescribe antibiotics. You may need surgery to relieve a prostate obstruction (see TURP).

## Alternative Names

[edit | edit source]

Delayed urination; Hesitancy; Difficulty initiating urination

## References

[edit | edit source]

Gerber GS, Brendler CB. Evaluation of the urologic patient: History, physical examination, and urinalysis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 3.

Landry DW, Bazari H. Approach to the patient with renal disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 116.

Zeidel ML. Obstructive uropathy. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 125.