What is Urinary Hesitancy?
Urinary hesitancy is a condition wherein the patient is having difficulty starting or maintaining a urine stream. This medical condition may occur both in men and women and of all ages. However, it is more evident in older men particularly those who are suffering from the enlarged prostate gland. The majority of older men encounter problems with starting urination, dribbling and usually experience a weak urine flow.
The parts that are affected if you have urinary hesitancy
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The condition typically develops over a period. Some people may only know they have the problem if they cannot urinate at all. The condition will lead to urine retention in the bladder that may cause inflammation and discomfort.
Urinary Hesitancy Causes
Urinary hesitancy can be due to various factors. Most of the time the medical condition is associated with problems of the nervous system, psychological issues, surgeries, and infections. Some of the typical reasons for urinary hesitancy are as follow: (1)
Some medications can cause urination problems in both men and women. The following drugs can cause urinary hesitancy:
- Nasal decongestants
- Cold and allergy drugs
- Some anticholinergics that are prescribed for stomach diseases like incontinence, muscular spasms, and cramps
- Some anti-depressants can also cause urinary hesitancy.
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An enlarged prostate is very common to older men. The inflammation caused by this enlargement may produce pressure on the urethra, which is the duct that carries the urine. The pressure on the urethra can affect the flow of the urine or difficulty in maintaining it.
Obstruction of Urethra
Aside from an enlarged prostate, other conditions can cause obstruction of the urethra. These include prostate infection and cancer. A stricture in the tube or scar tissue may result to the bladder and can block the urine. This may occur in both men and women. Other causes for urethra obstruction include infection, stones, tumors, injury, and blood clots in the pelvic area.
When a problem occurs in the nerves between the bladder and the brain, people may experience difficulties in controlling their bladder function. This medical condition is known as neurogenic bladder.
An infection can cause urinary hesitancy in the pelvic area. The infection may result in interference in the nerves in the pelvic.
One of the common problems after surgery is urinary retention. This is due to the anesthetics used during surgery. The substance can impair the normal functioning of the nerves that is responsible for maintaining the healthy stream of urine.
Shy Bladder Condition (Paruresis)
Urinary hesitancy can also be due to psychological issues where people find it hard to urinate in front of other people.
The first thing your doctor will ask you to diagnose the cause of your condition is your medical history. Your physician may ask the following questions: (2)
- How long have you been experiencing the condition?
- If it developed right away or gradually
- Do you have a weak urine flow
- Is there anything that worsens or relieves your symptoms
Your physician may also ask other symptoms that you are having. Don’t forget to mention other medical conditions aside from the one you are already experiencing. It is also important that you inform your doctor about the medications or supplements that you are taking.
The physician may recommend further tests to help determine the cause of your condition. For instance, they may collect a urine sample for analysis. Swabbing your urethra is also a test that your doctor may consider. In some cases, they may need to place a small flexible in your urethra. This will enable them to collect urine sample directly from your urinary bladder.
The following urodynamic studies may be conducted:
It measures the flow rate, and volume of urine excreted when you urinate.
Pressure flow testing
A catheter is needed to gauge the pressure in the bladder, which is then compared to the flow rate as you urinate.
Video urodynamic testing
It makes use of a particular substance placed in the bladder thru catheter to create a contrast imaging during filling and emptying of the urinary bladder.
The rectal prostate exam may be done for male patients. The doctor may also request for imaging technology and prostate ultrasound.
Treatment & Home Remedies
The treatment plan may vary depending on the underlying cause of your symptoms. The doctor may recommend surgery, medications or other treatments. In most cases, home remedies may help treat the symptoms.
Heat is the most common medication used in treating urination problems. To help relax the muscles of the bladder, you can place a hot water bottle or bag on the lower abdomen to ease the flow of urine. Massage the bladder gently and apply light pressure on it to help in releasing the urine in the bladder. Drinking lots of fluids can also contribute to resolving your urine problem.
If the problem reoccurs, again and again, you should talk to your doctor right away. Visit your doctor right away once you experience difficulties in urinating particularly if it is associated with fever, severe back pain and vomiting is advised.
Other conditions that require immediate doctor’s attention: (3)
- Forcing or straining to start the urine flow.
- Frequent pass of urine in the morning or at night
- Having a strong urge to pass urine right away when the bladder is full.
- Hematuria or blood in the urine
- If the hesitancy worsens
- If you feel that your bladder is still full even after urination
- In the presence of other urinary symptoms
- Incontinence or involuntary leakage of urine
- Painful urination or dysuria
- Starting or stopping of the urinary stream (intermittency)
- Stranguria or weak stream