Call your doctor right away if:

• You have fever, vomiting, side or back pain, shaking chills, or are passing little urine for 1-2 days
• You have blood in your urine, cloudy urine, frequent or urgent need to urinate, or a discharge from the penis or vagina
• You are unable to pass urine

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 gradually 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? Neurologic disorders?
• Have you had a recent injury, surgery, or diagnostic procedures on the pelvis or bladder?
• What medications do you take, including over-the-counter drugs?

Diagnostic tests that may be performed include:

• Urinalysis and culture
• Urethral swab for culture
• Transrectal ultrasound of the prostate (similar to a transvaginal ultrasound)
• Catheterization of the bladder to determine residual urine volume and to obtain urine for culture (a catheterized urine specimen)
• Cystometrography
• Voiding cystourethrogram

Treatment of urinary hesitancy varies depending on the underlying cause. Often, medications such as alpha blockers can relieve the symptoms. If a bacterial infection is present, antibiotics may be prescribed. A surgical procedure may be required to relieve prostate obstruction (see TURP).

Images

Female urinary tract

Male urinary tract

• < Page
1 2
• >

Review Date: 09/30/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Scott Miller, MD, Urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)