Having difficulty urinating, medically referred to as urinary hesitancy, can be frustrating and concerning. This condition can make it hard to start urinating, maintain a steady stream, or fully empty the bladder. While it can affect anyone, urinary hesitancy is more common in men due to anatomical and age-related factors. However, women can also experience it, often for different reasons. Whether urinary hesitancy affects a man or woman, it will be critical to find the root cause in order to effectively treat and manage it.
What Causes Difficulty Urinating?
Urinary hesitancy can result from various physical, neurological, or medication-related factors. Below are some of the most common causes:
1. Enlarged Prostate in Men (Benign Prostatic Hyperplasia, BPH)
One of the most frequent culprits in men is BPH, a condition in which the prostate gland enlarges and compresses the urethra, making it harder for urine to pass through.
2. Bladder Prolapse in Women
For women, bladder prolapse—also called a “fallen bladder”—is a common cause. When the bladder shifts out of its normal position, it can block the urethra, making it difficult to urinate.
3. Scar Tissue in the Urethra
Scar tissue, or urethral stricture, can narrow the urethra and obstruct urine flow. This may result from previous injuries, surgeries, or catheter use.
4. Medications
Certain drugs, such as antidepressants and decongestants containing pseudoephedrine, can interfere with bladder function. These medications may disrupt the nerve signals that control urination.
5. Neurological Disorders
Conditions like multiple sclerosis or diabetic neuropathy can damage the nerves responsible for bladder function, making it difficult to empty the bladder effectively.
6. Pelvic Floor Dysfunction
Chronic stress or tension in the pelvic floor muscles can prevent them from relaxing during urination, leading to urinary hesitancy.
7. Pelvic Organ Prolapse in Women
A prolapsed uterus or vaginal wall can compress the urethra, creating an obstruction that makes urination challenging.
Why You Shouldn’t Ignore Urinary Hesitancy
Urinary hesitancy may be viewed as minor inconvenience, but if not treated, it can lead to serious complications, including:
Bladder Infections: Incomplete emptying of the bladder creates an environment for bacteria to grow.
Kidney Damage: Prolonged bladder pressure can back up to the kidneys, potentially causing long-term harm.
Urosepsis: Urinary hesitance can be a sigh of a urinary tract infection (UTI). If the UTI is not treated, there is the potential for it to progress to sepsis or urosepsis, which is considered a serious condition. Individuals more prone to urosepsis include those with a weakened immune system or other underlying health conditions.
Early intervention is key. If you notice a progressive decline in your ability to urinate, consult a healthcare provider before the issue worsens.
Solutions for Urinary Hesitancy
The good news is there are various treatments effective for urinary hesitancy, depending on the cause. Here are some common approaches:
1. Timed Voiding
Establishing a schedule to urinate every three hours can prevent the bladder from becoming overly full for mild cases. Double voiding—attempting to urinate again right after the first attempt—can also help.
2. Warm Baths
Taking a warm bath will help relax the pelvic floor muscles, making urination easier.
3. Physical Therapy
Specialized exercises targeting the pelvic floor can improve muscle coordination and relaxation, especially for those with pelvic floor dysfunction.
4. Sacral Nerve Stimulation
An implanted device can stimulate the sacral nerve, which controls bladder function. This “bladder pacemaker” is particularly effective for people with nerve-related issues.
5. Medications
For Men: Drugs that shrink the prostate or relax the urethral muscles can improve urinary flow.
For Women: Vaginal benzodiazepine suppositories can help relax pelvic floor muscles without causing sedative or addictive side effects.
6. Surgery
For Men: Prostate surgery, such as prostate reduction or vaporization, can alleviate obstruction caused by BPH.
For Women: Surgery to reposition prolapsed pelvic organs can resolve urinary hesitancy by removing the obstruction.
For Both: Surgical removal of scar tissue in the urethra can restore proper urinary flow.
Take Action
Urinary hesitancy is a condition that should not be ignored. It often develops gradually, making it easy to dismiss until it becomes severe. If you notice changes in your urination ability, talk to your doctor. The earlier it is diagnosed and treated, the less chance of serious complications. By understanding the potential causes and exploring available treatments, you can take control of your urinary health and find solutions that work for you.Dr. David Samadiis the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Dr. Samadi is a medical contributor to NewsMax TV and is also the author of two books, Prostate Cancer, Now What? A Practical Guide to Diagnosis, Treatment, and Recovery, and The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.
