Urinary hesitancy

For patient information click here

WikiDoc Resources for Urinary hesitancy
Articles
Most recent articles on Urinary hesitancy Most cited articles on Urinary hesitancy Review articles on Urinary hesitancy Articles on Urinary hesitancy in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Urinary hesitancy Images of Urinary hesitancy Photos of Urinary hesitancy Podcasts & MP3s on Urinary hesitancy Videos on Urinary hesitancy
Evidence Based Medicine
Cochrane Collaboration on Urinary hesitancy Bandolier on Urinary hesitancy TRIP on Urinary hesitancy
Clinical Trials
Ongoing Trials on Urinary hesitancy at Clinical Trials.gov Trial results on Urinary hesitancy Clinical Trials on Urinary hesitancy at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Urinary hesitancy NICE Guidance on Urinary hesitancy NHS PRODIGY Guidance FDA on Urinary hesitancy CDC on Urinary hesitancy
Books
Books on Urinary hesitancy
News
Urinary hesitancy in the news Be alerted to news on Urinary hesitancy News trends on Urinary hesitancy
Commentary
Blogs on Urinary hesitancy
Definitions
Definitions of Urinary hesitancy
Patient Resources / Community
Patient resources on Urinary hesitancy Discussion groups on Urinary hesitancy Patient Handouts on Urinary hesitancy Directions to Hospitals Treating Urinary hesitancy Risk calculators and risk factors for Urinary hesitancy
Healthcare Provider Resources
Symptoms of Urinary hesitancy Causes & Risk Factors for Urinary hesitancy Diagnostic studies for Urinary hesitancy Treatment of Urinary hesitancy
Continuing Medical Education (CME)
CME Programs on Urinary hesitancy
International
Urinary hesitancy en Espanol Urinary hesitancy en Francais
Business
Urinary hesitancy in the Marketplace Patents on Urinary hesitancy
Experimental / Informatics
List of terms related to Urinary hesitancy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: hesitancy; delayed urination; difficulty initiating urination; weak urine stream

Overview

Urinary hesitancy is defined as difficulty in initiating and maintaining a flow of urine.

Causes

Common Causes

• Anticholinergics
• Benign prostatic hyperplasia
• Prostatic cancer
• Prostatitis
• Shy bladder syndrome
• Tricyclic antidepressants
• Urinary tract infection
• Urinary tract obstruction

Causes by Organ System

Cardiovascular	No underlying causes
Chemical / poisoning	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Amitriptyline, Amoxapine, Anticholinergics, Hyoscyamine, Nasal decongestants, Norpramin, Orphenadrine, Pamelor, Repaglinide, Sinequan, Surmontil, Tofranil, Tricyclic antidepressants, Vivactil
Ear Nose Throat	No underlying causes
Endocrine	Diabetes mellitus
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	Blood clot in the urethra
Iatrogenic	Recovery from general anesthesia
Infectious Disease	Herpes genitalis, Herpes zoster, Tabes dorsalis, Urinary tract infection, Prostatitis
Musculoskeletal / Ortho	Secondary tumor deposits in vertebra
Neurologic	Multiple sclerosis, Pudendal nerve entrapment, Spinal cord lesions, Syringomyelia, Transverse myelitis, Tabes dorsalis, Tumor of the spinal meninges, Tumor of the spinal cord
Nutritional / Metabolic	No underlying causes
Obstetric/Gynecologic	Retroverted pregnancy, Uterine fibroids, Vaginal carcinoma
Oncologic	Secondary tumor deposits in vertebra, Tumor of the spinal meninges, Urethral carcinoma, Vaginal carcinoma , Prostatic cancer
Opthalmologic	No underlying causes
Overdose / Toxicity	Amitriptyline, Amoxapine, Anticholinergics, Nasal decongestants, Norpramin, Pamelor, Sinequan, Surmontil, Tofranil, Tricyclic antidepressants, Vivactil
Psychiatric	Bashful bladder syndrome, Shy bladder syndrome
Pulmonary	No underlying causes
Renal / Electrolyte	No underlying causes
Rheum / Immune / Allergy	Multiple sclerosis, Transverse myelitis
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	Bashful bladder syndrome, Benign prostatic hyperplasia, Benign prostatic hypertrophy, Bladder diverticulum, Blood clot in the urethra, Meatal stenosis, Poor bladder contractility, Posterior strictures in males, Primary bladder neck dysfunction, Prostatic cancer, Prostatitis, Shy bladder syndrome, Tight phimosis, Tumor of the spinal cord, Urethral stricture, Urinary tract obstruction, Urinary tract infection, Urethral carcinoma, Reflux nephropathy
Dental	No underlying causes
Miscellaneous	No underlying causes

Causes in Alphabetical Order

Amitriptyline Amoxapine Anticholinergics Bashful bladder syndrome Benign prostatic hyperplasia Benign prostatic hypertrophy Bladder diverticulum Blood clot in the urethra Diabetes mellitus Herpes genitalis Herpes zoster Meatal stenosis Multiple sclerosis Nasal decongestants Norpramin Pamelor Poor bladder contractility Posterior strictures in males Primary bladder neck dysfunction Prostatic cancer Prostatitis Pudendal nerve entrapment

Recovery from general anesthesia Reflux nephropathy Retroverted pregnancy Secondary tumor deposits in vertebra Shy bladder syndrome Sinequan Spinal cord lesions Surmontil Syringomyelia Tabes dorsalis Tight phimosis Tofranil Transverse myelitis Tricyclic antidepressants Tumor of the spinal cord Tumor of the spinal meninges Urethral carcinoma Urethral stricture Urinary tract infection Urinary tract obstruction Uterine fibroids Vaginal carcinoma Vivactil

Epidemiology and Demographics

Urinary hesitancy is observed in both genders at all ages. It tends to affect elderly males more frequently.

Diagnosis

Laboratory Studies

The following diagnostic studies may be of use:

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

Treatment

Treatment for urinary hesitancy depends on the cause. Often, medications such as alpha-blockers can relieve the symptoms. If you have a bacterial infection, your health care provider may prescribe antibiotics. You may need surgery to relieve a prostate obstruction (see TURP).