Urinary hesitancy (patient information): Difference between revisions
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For doctor information click [[Urinary hesitancy|here]] | |||
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== Considerations == | == Considerations == | ||
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* Weaker urine stream | * Weaker urine stream | ||
Causes | ==Causes== | ||
Urinary hesitancy can be caused by: | Urinary hesitancy can be caused by: | ||
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* Urinary tract infection | * Urinary tract infection | ||
Home Care | ==Home Care== | ||
* Monitor, record, and report your urination patterns to your doctor. | * Monitor, record, and report your urination patterns to your doctor. | ||
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* [http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000395.htm Prostatitis - bacterial - self-care] | * [http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000395.htm Prostatitis - bacterial - self-care] | ||
When to Contact a Medical Professional | ==When to Contact a Medical Professional== | ||
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 for urinary hesitancy, dribbling, or a weak urine stream if you have not already been evaluated for these problems. | ||
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Call your doctor right away if: | Call your doctor right away if: | ||
* You have a [ | * 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 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 | * You are unable to pass urine | ||
What to Expect at Your Office Visit | ==What to Expect at Your Office Visit== | ||
Your doctor will take your medical history and perform a physical examination, paying special attention to your pelvis, rectum, abdomen, and lower back. | Your doctor will take your medical history and perform a physical examination, paying special attention to your pelvis, rectum, abdomen, and lower back. | ||
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* [http://www.nlm.nih.gov/medlineplus/ency/article/003784.htm Voiding cystourethrogram] | * [http://www.nlm.nih.gov/medlineplus/ency/article/003784.htm Voiding cystourethrogram] | ||
==Treatment== | |||
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 [http://www.nlm.nih.gov/medlineplus/ency/article/000381.htm prostate obstruction] (see [http://www.nlm.nih.gov/medlineplus/ency/article/002996.htm TURP]). | 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 [http://www.nlm.nih.gov/medlineplus/ency/article/000381.htm prostate obstruction] (see [http://www.nlm.nih.gov/medlineplus/ency/article/002996.htm TURP]). | ||
Revision as of 00:24, 20 August 2012
For doctor information click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Considerations
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
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 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
- 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:
When to Contact a Medical Professional
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
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:
- 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
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
Delayed urination; Hesitancy; Difficulty initiating urination
References
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.