Urinary hesitancy occurs when a person has problems with urination involving starting or maintaining a stream of urine. While it is most common in older males due to an enlarged prostate, it can happen to anyone of any age.

This article will look at the causes, symptoms, and treatments of urinary hesitancy.

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

Without treatment, urinary hesitancy may develop into urinary retention. Urinary retention occurs when a person is unable to void their bladder completely. It is a medical emergency.

There are several possible causes of urinary hesitancy. Some can affect anyone, while others only affect one sex.

Some of the most common causes include:

A person may experience urinary hesitancy on its own or as part of a wider underactive bladder symptom complex. However, medical professionals are yet to define this complex formally.

Multiple sclerosis may also cause bladder dysfunction, including urinal hesitancy.

Typical causes for males

One common cause of urinary hesitancy in males is a benign enlarged prostate. Although this is the most common cause in older males, an enlarged prostate can also affect younger males. As many as 50% of males experience symptoms of an enlarged prostate by age 60 years.

The prostate is a gland unique to males 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 male to start or maintain a urine stream.

Also, males may experience inflammation of the prostate due to infection. This is called prostatitis. Some studies report that bacterial inflammation of the prostate may also result in urinary hesitancy.

Typical causes for females

Females may develop urinary hesitancy during pregnancy and after childbirth.

According to a 2014 study, some females may also experience urinary retention post-childbirth. Some significant risk factors for the development of postpartum urinary hesitancy and retention include:

An analysis of pelvic floor dysfunction suggests that this may also cause urinary hesitancy in females. UTIs are another common cause.

If a person experiences urinary hesitancy occasionally, it is not usually a cause for concern. However, if symptoms are persistent or recurring, the person should contact a doctor.

Before treatment, a doctor will likely perform a noninvasive 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 the symptoms better or worse?

A doctor may examine a person for further lower urinary tract dysfunction. For males, a doctor may conduct a prostate exam, imaging studies, or urodynamic studies.

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

Some standard treatments include:

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

There are several remedies that a person can try at home that may potentially alleviate urinary hesitancy. These steps often involve minimal effort and are usable alongside medical care.

However, it is essential to note that these remedies are purely anecdotal and are not medically proven to alleviate urinary hesitancy.

Some potential 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
  • doing Kegel exercises
  • limiting fluid intake
  • bladder training

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

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

Over time, urinary hesitancy may develop into urinary retention. This can cause swelling and discomfort in the bladder and is a medical emergency.

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

Even in non-severe cases, ignoring a weak urine flow or difficulty starting urination can allow the condition to worsen. Eventually, this may lead to urinary retention, which may require surgery.

The type of surgery a person undergoes will depend on the underlying causes of the condition and on current guidelines.

Acute urinary retention, or the sudden and complete inability to urinate, is a severe condition that requires immediate medical attention. Without treatment, it can lead to serious health problems.

Urinary hesitancy refers to when a person has difficulty starting or maintaining a stream of urine. Urinary hesitancy predominantly affects older males but can affect people of all ages and sexes.

Urinary hesitancy has many potential causes, including bladder obstructions, an enlarged prostate, and complications related to childbirth.

If a person consistently experiences urinary hesitancy, they should contact a doctor. The inability to pass urine at all is called urinary retention and is a medical emergency.