Urinary hesitancy describes a difficulty in passing urine that may involve starting or maintaining the flow of liquid waste. It can affect people of both sexes and all ages, though it is most common in older males. Urinary hesitancy is usually a gradual phenomenon that worsens with time. Often, it does not become troublesome until the problem is severe enough to cause discomfort due to impact upon the bladder. Urinary hesitancy can be caused by a variety of factors.
A major cause of urinary hesitancy is enlarged prostate or benign prostatic hyperplasia. The prostate is a male sexual organ that secretes fluid found in semen. The cause of prostate enlargement is unknown, but it is quite common, occurring in 90 percent of men aged 80 and order. As the prostate enlarges, it can press upon the outlet of the bladder, making it difficult for urine to pass out of it and through the urethra, which results in urinary hesitancy. Prostatitis, an infection of the prostate that causes inflammation, can have similar effects upon urination in males.
Urinary Tract Infections
Urinary Tract Infections or UTIs occur when bacteria enters the urinary tract through the urethra. The urinary tract often becomes inflamed due to the infection, leading to difficulty passing urine as well as difficulty in emptying the bladder. This can lead to urinary hesitancy, especially if the infections are recurrent. Urinary tract infections are most common in women, but also frequently affect infants and young children. People with diabetes are also more susceptible to UTIs.
Certain medications can cause urinary hesitancy through inflammation of the urinary tract or by affecting the bladder. Some over-the-counter cold medicines and nasal decongestants can affect the output of urine leading to difficulty in starting the flow of urine. Tricyclic antidepressants such as Amitriptyline, Amoxapine, Norpramin, Sinequan, Tofranil, Pamelor, Vivactil and Surmontil cause similar effects. In addition, anticholinergics that are used to treat urinary incontinence can have the adverse effect of causing urinary hesitation in some patients.
Shy Bladder Syndrome
Shy Bladder Syndrome or Paruresis is a social phobia that makes it difficult or affects individuals from urinating in the presence of others. It is a form of Social Anxiety Disorder, meaning that the difficulty originates in thought processes that then cause physical affects upon the body. People with Shy Bladder Syndrome may experience urinary hesitancy in public restrooms or in locations where they believe people may walk in on them or overhear them as they urinate.
At the first sign of urinary hesitancy, it is advised by Medline Plus to begin monitoring the frequency and difficulty of urination in order to report it to a medical professional if necessary. If experiencing urinary hesitation for the first time, it is necessary to be seen by a doctor to diagnose the cause. If accompanied by fever, vomiting, side or back pain, trembling or chills, urinary hesitancy should be assessed by a medical professional as soon as possible. Additionally, those with urinary hesitancy should monitor their urine to look for blood or cloudiness which could be sign of an infection that requires medical treatment.