Summary about Disease
Urinary hesitancy is difficulty starting or maintaining a urine stream. It's characterized by a delay between trying to urinate and the actual flow of urine beginning. The strength of the urine stream may also be diminished. It's more common in men, especially as they age, but can also affect women.
Symptoms
Difficulty starting urination
Straining to urinate
Weak urine stream
Feeling that the bladder is not completely empty after urination
Dribbling after urination
Increased frequency of urination, especially at night (nocturia)
Urgency to urinate
Causes
Benign Prostatic Hyperplasia (BPH): Enlarged prostate in men, compressing the urethra.
Prostatitis: Inflammation of the prostate gland.
Urethral Stricture: Narrowing of the urethra.
Nerve Damage: Conditions like diabetes, multiple sclerosis, or spinal cord injury can affect bladder control.
Medications: Certain medications, such as antihistamines, decongestants, and some antidepressants, can contribute.
Surgery: Pelvic surgery can sometimes damage nerves affecting urination.
Bladder stones or tumors: Obstruction of the bladder outlet.
Constipation: Severe constipation can put pressure on the bladder and urethra.
Psychological Factors: Anxiety or stress can sometimes contribute to urinary hesitancy.
Medicine Used
The medications used depend on the underlying cause. Common categories include:
Alpha-blockers: (e.g., tamsulosin, alfuzosin) Relax muscles in the prostate and bladder neck, making it easier to urinate (primarily for BPH).
5-alpha-reductase inhibitors: (e.g., finasteride, dutasteride) Shrink the prostate gland over time (primarily for BPH).
Antibiotics: For prostatitis caused by bacterial infection.
Anticholinergics or Beta-3 agonists: To treat overactive bladder symptoms, sometimes used in conjunction with other treatments.
Is Communicable
No, urinary hesitancy itself is not communicable. The underlying causes, like prostatitis caused by a sexually transmitted infection, could be communicable, but the hesitancy itself is not.
Precautions
Maintain good hydration, but avoid excessive fluid intake before bedtime.
Avoid or limit caffeine and alcohol, as they can irritate the bladder.
Manage constipation through diet and lifestyle changes.
Practice double voiding: After urinating, wait a few moments and try to urinate again.
Maintain a regular urination schedule.
Avoid holding urine for long periods.
If taking medications that contribute to hesitancy, discuss alternatives with your doctor.
How long does an outbreak last?
Urinary hesitancy is not an outbreak. It is a chronic condition or symptom of an underlying condition. The duration depends entirely on the cause and how effectively it's treated. It can range from temporary (e.g., related to a medication) to chronic and progressive (e.g., BPH).
How is it diagnosed?
Medical History and Physical Exam: Doctor will ask about symptoms, medical history, and perform a physical examination, including a prostate exam in men.
Urinalysis: To check for infection or blood in the urine.
Postvoid Residual (PVR) Measurement: Measures the amount of urine left in the bladder after urination using ultrasound or catheterization.
Uroflowmetry: Measures the rate and volume of urine flow.
Cystoscopy: A thin, flexible tube with a camera is inserted into the urethra to visualize the urethra and bladder.
Prostate-Specific Antigen (PSA) Test: A blood test to screen for prostate cancer (especially in men).
Urodynamic Studies: More comprehensive tests to evaluate bladder function.
Timeline of Symptoms
The timeline of symptoms varies widely.
Sudden onset: May suggest acute prostatitis or medication side effect.
Gradual onset: More typical of BPH or urethral stricture.
Intermittent: May be related to constipation, anxiety, or specific triggers. There is no set "timeline" as it's dependent on the root cause. The key is to note when symptoms started, how they've progressed, and any associated factors.
Important Considerations
Don't self-diagnose: Urinary hesitancy can be a symptom of serious underlying conditions. See a doctor for evaluation.
Be honest with your doctor: Provide a complete medical history and list of medications.
Follow your doctor's recommendations: Treatment success depends on adherence to prescribed medications and lifestyle changes.
Monitor for complications: Untreated urinary hesitancy can lead to urinary retention, urinary tract infections, bladder damage, and kidney damage.
Men should have regular prostate exams: Especially as they age, to screen for BPH and prostate cancer.