Urinary hesitancy: Causes, symptoms, and treatment

Urinary hesitancyUrinary hesitancy is defined as having difficulty starting or maintaining a steady urine stream. The condition can occur at any age and affects both males and females. However, it is commonly seen in older men with an enlarged prostate gland. Urinary hesitancy develops over time, with suffers often facing problems with urination, dribbling, or not being able to urinate at all. If left untreated, it can lead to urine retention in the bladder and cause inflammation and discomfort.

What causes urinary hesitancy?


Certain cold treatment medications, nasal decongestants, and anti-allergy medications can affect your urination. A class of medications known as anticholinergics used to treat muscle spasms and incontinence has the side effect of causing urinary retention and hesitancy. The use of antidepressant type medication may also affect urinary habits.

Enlarged prostate


A gland found exclusively in men that surrounds the urethra. The prostate gland commonly becomes enlarged as men age, putting pressure on the urethra and making it harder to pass and maintain urine flow.

Obstruction of the urethra

Prostate cancer, prostate enlargement, scar tissue, urinary stones, and even pelvic tumors can block the flow of urine coming from the bladder.

Related: Urinary bladder neck obstruction: Causes and treatments

Nerve problems

Nerve damage can occur due to strokes, unavoidable accidents, childbirth, or even brain and spinal cord infections. The nerves controlling the actions of the bladder and other urinary structures can interfere with the flow of urine. Multiple sclerosis is a condition characterized by demyelination of nerve cells, which can subsequently lead to nerve damage affecting virtually any part of the body.


Inflammation of the prostate gland, also known as prostatitis, is due to infection and causes the prostate to swell up, putting pressure on the urethra. Urinary tract infections and sexually transmitted infections can also lead to issues of urinary hesitancy.


Procedures involving the bladder, kidneys, or urethra can create scar tissue that obstructs urine outflow. Also, many surgeries require patients to be put under anesthesia, which carries the risk of impairing nerves.


Also know has “shy bladder syndrome,” this condition may be a sign of a psychological condition. It is characterized by feelings of being uncomfortable when urinating in the presence of others, with those affected finding it hard to urinate in these conditions. This often leads to urinary hesitancy when using public bathrooms.

When to see doctor

If you experience any of the following symptoms, it is recommended to see a doctor as soon as possible to find a resolution.

  • Urinary hesitancy is becoming worse
  • Increased frequency of urinary hesitancy or nighttime urination (nocturia)
  • Feeling a very strong urge to pass urine immediately when the bladder is full (urinary urgency)
  • Pushing or straining to start the urine flow
  • Having a weak urine stream (stranguria)
  • Stopping and starting of the urinary stream (urinary intermittency)
  • Feelings of incomplete bladder emptying after urination
  • Pain when urinating (dysuria)
  • Involuntary leakage of urine (incontinence)
  • Blood in the urine (hematuria)
  • Fever
  • Vomiting
  • Chills
  • Low back pain

How to diagnose urinary hesitancy

When visiting your doctor about your urinary problems, they’ll first ask a little about your medical background to find out if you have a predisposition to urinary tract conditions. This also includes a detailed description of your urinary hesitancy symptoms, such as how long you’ve had it, the strength of your flow, and what makes your condition better or worse. Disclosing any currently used medication will also help the doctor rule out any other causes.

Once all the necessary information has been gathered, various tests will be done to determine the cause of your symptoms. This will include obtaining a urine sample and a swab from the inside of your urethra, likely to isolate any causative bacterial infections. The following are some additional tests your doctor may feel are necessary:

  • Uroflowmetry: Measures the volume and flow of urine being expelled from the bladder.
  • Pressure flow testing: With the use of a catheter, the pressure of the bladder can be measured, which can then be compared to the flow rate while urinating.
  • Video urodynamic testing: With the aid of contrast liquid, this test highlights the abnormality with your bladder.

How to get rid of urinary hesitancy


Treatment of urinary hesitancy depends on the cause of your symptoms. This may involve the utilization or various types of medication, surgery, or other therapies. However, there are some things you can do on your own to help relieve your symptoms of urinary hesitancy. These may include:

  • Hot water bottle: Heat treatment is a well-known and effective method for reducing pain caused by urinary issues. Using a water bottle, fill it up with hot water and place it on the abdomen. This will help relax bladder muscles, easing urine flow.
  • Bladder massage: By lightly applying light pressure over the bladder you can help with bladder emptying.
  • Drink plenty of water: This will help make sure you are maintaining a regular urine flow.

It is not advised to ignore urinary hesitancy or any other problems involving the urinary tract. Regular urination is required for healthy functioning, so it should be treated with utmost importance when issues arise. While you can temporarily help relieve symptoms on your own, only a doctor can provide you with the necessary treatment.

Related: Are urinary tract infections (UTIs) contagious?

Author Bio

Devon Andre has been involved in the health and dietary supplement industry for a number of years. Devon has written extensively for Bel Marra Health. He has a Bachelor of Forensic Science from the University of Windsor, and went on to complete a Juris Doctor from the University of Pittsburgh. Devon is keenly aware of trends and new developments in the area of health and wellness. He embraces an active lifestyle combining diet, exercise and healthy choices. By working to inform readers of the options available to them, he hopes to improve their health and quality of life.



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