Urinary hesitancy

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

Synonyms and Keywords: hesitancy; delayed urination; difficulty initiating urination; weak urine stream


Urinary hesitancy is defined as difficulty in initiating and maintaining a flow of urine.


Common Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical / poisoning No underlying causes
Dermatologic No underlying causes
Drug Side Effect Amitriptyline, Amoxapine, Anticholinergics, Hyoscyamine, Nasal decongestants, Norpramin, Orphenadrine, Pamelor, Repaglinide, Sinequan, Surmontil, Tofranil, Tricyclic antidepressants, Vivactil
Ear Nose Throat No underlying causes
Endocrine Diabetes mellitus
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic Blood clot in the urethra
Iatrogenic Recovery from general anesthesia
Infectious Disease Herpes genitalis, Herpes zoster, Tabes dorsalis, Urinary tract infection, Prostatitis
Musculoskeletal / Ortho Secondary tumor deposits in vertebra
Neurologic Multiple sclerosis, Pudendal nerve entrapment, Spinal cord lesions, Syringomyelia, Transverse myelitis, Tabes dorsalis, Tumor of the spinal meninges, Tumor of the spinal cord
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic Retroverted pregnancy, Uterine fibroids, Vaginal carcinoma
Oncologic Secondary tumor deposits in vertebra, Tumor of the spinal meninges, Urethral carcinoma, Vaginal carcinoma , Prostatic cancer
Opthalmologic No underlying causes
Overdose / Toxicity Amitriptyline, Amoxapine, Anticholinergics, Nasal decongestants, Norpramin, Pamelor, Sinequan, Surmontil, Tofranil, Tricyclic antidepressants, Vivactil
Psychiatric Bashful bladder syndrome, Shy bladder syndrome
Pulmonary No underlying causes
Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy Multiple sclerosis, Transverse myelitis
Sexual No underlying causes
Trauma No underlying causes
Urologic Bashful bladder syndrome, Benign prostatic hyperplasia, Benign prostatic hypertrophy, Bladder diverticulum, Blood clot in the urethra, Meatal stenosis, Poor bladder contractility, Posterior strictures in males, Primary bladder neck dysfunction, Prostatic cancer, Prostatitis, Shy bladder syndrome, Tight phimosis, Tumor of the spinal cord, Urethral stricture, Urinary tract obstruction, Urinary tract infection, Urethral carcinoma, Reflux nephropathy
Dental No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

Epidemiology and Demographics

Urinary hesitancy is observed in both genders at all ages. It tends to affect elderly males more frequently.


Laboratory Studies

The following diagnostic studies may be of use:


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).