Urinary hesitation is when a person has trouble starting or maintaining a urine stream. While urinary hesitancy is most common in older men due to an enlarged prostate, it can happen to both men and women of any age.

Anyone who experiences symptoms of urinary hesitancy should speak to a doctor who can rule out any underlying causes.

In this article, learn about the causes of urinary hesitancy for men and women as well as how to treat and prevent symptoms.

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Being given an anesthetic during surgery may cause urinary hesitancy in both men and women.

There is a wide range of possible causes of urinary hesitancy. Some affect both men and women, while others only affect one sex.

Some of the most common causes include:

Typical causes for men

One common cause of urinary hesitancy in men is a benign, enlarged prostate. This is the most common cause in older men, but an enlarged prostate can affect younger men as well.

The prostate is a gland unique to men that surrounds the urethra. The urethra is a tube that transports urine out of the body. As the prostate enlarges over time, it puts pressure on the urethra. This increasing pressure may make it difficult for a man to start or maintain a urine stream.

Also, men may experience an inflammation of the prostate called prostatitis. Infections are often the cause of prostatitis. The inflammation puts pressure on the area around the urethra and may make it difficult to urinate.

Typical causes for women

Women are not as likely to develop urinary hesitancy as men. However, women can develop urinary hesitancy during pregnancy and after childbirth.

Women are most likely to develop urinary hesitancy after childbirth if they experience any of the following:

  • prolonged second stage of labor
  • episiotomy
  • perineal tearing
  • use of forceps or vacuum during childbirth
  • epidural use
  • baby weighing over 4000 grams

Urinary hesitancy is relatively common after childbirth due to trauma to the nerves surrounding the bladder and urinary tract.

Proper postpartum bladder care, including voiding the bladder at least once every 6 hours, can help prevent and relieve urinary hesitancy after childbirth.

Urinary tract infections are another common cause of urinary hesitancy in women.

Occasional urinary hesitancy is often not a cause for concern. However, if symptoms are persistent or recurring, a person should see a doctor.

Before treatment, a doctor will likely perform a physical examination and ask the person questions about their symptoms. These questions may include:

  • Did the urinary hesitancy come on suddenly or gradually?
  • Are there other symptoms, such as fever or pain?
  • How long have the symptoms been happening?
  • Is the urine flow weak?
  • Does anything make symptoms better or worse?

A doctor may also perform tests to look for any underlying causes. The doctor may require a urine sample. For men, a common test is a prostate exam or imaging. Other tests include an examination of the urine.

The treatment will depend on the underlying cause of urinary hesitancy.

Some standard treatments include:

  • antibiotics for infections
  • medicines for enlarged prostate
  • surgery to relieve a prostate blockage
  • procedures to dilate the urethra
  • removal of scar tissue within the urethra

In addition to traditional treatments, there are some steps that a person can take at home to help ease symptoms.

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Having a warm bath may help ease urinary hesitancy.

There are several remedies a person can do at home to help alleviate urinary hesitancy. These steps often involve minimal effort and can be used alongside medical care.

Home remedies for urinary hesitancy include:

  • taking a warm bath or shower
  • using a hot water bottle or heating pad on the abdomen
  • massaging the bladder area
  • keeping a record of urination patterns to identify triggers

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Although more common in older men, urinary hesitation can affect men and women of any age.

The main symptom of urinary hesitancy is difficulty starting or maintaining a urine stream.

Urinary hesitation often develops slowly over time. The slow onset may make the condition difficult to identify until a person loses the ability to empty the bladder completely.

When a person cannot fully empty their bladder, it is called urinary retention. This can also cause swelling and discomfort in the bladder and is a medical emergency.

Other people may be able to identify urinary hesitation before it develops into urinary retention. In these cases, a person may have trouble starting urination or may find it difficult to maintain a steady flow of urine once started.

A person who has urine hesitancy should seek immediate attention if they experience any of the following:

  • inability to urinate at all
  • fever
  • shaking
  • lower back pain
  • chills
  • vomiting

Even in non-severe cases, ignoring the symptoms of weak urine flow or trouble starting urination can allow the condition to worsen. Eventually, it may lead to urinary retention, which is when a person cannot empty their bladder completely.

Acute urinary retention or the sudden and complete inability to urinate is a serious condition that requires immediate medical attention. It can lead to serious health problems if left untreated.

A person experiencing urinary hesitation should also look for signs of an infection, such as a fever or pain.

A person should never ignore persistent or recurring urinary hesitancy. The condition can get worse over time and may eventually lead to a complete inability to urinate.

A person should seek medical attention when they first notice symptoms of urinary hesitancy. A doctor can rule out underlying causes and prevent the symptoms from getting worse.