View source for Urinary hesitancy

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For patient information click [[Urinary hesitancy (patient information)|here]]
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{{SK}} hesitancy; delayed urination; difficulty initiating urination

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

==Causes==

=== Common Causes ===

=== Causes by Organ System ===

{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Amitriptyline]], [[Amoxapine]], [[Anticholinergics]], [[Nasal decongestants]], [[Norpramin]], [[Pamelor]], [[Sinequan]], [[Surmontil]], [[Tofranil]], [[Tricyclic antidepressants]], [[Vivactil ]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|- 
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| [[Diabetes mellitus]]
|- 
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Blood clot in the urethra]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| [[Recovery from general anesthesia]]
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| [[Herpes genitalis]], [[Herpes zoster]], [[Tabes dorsalis]], [[Urinary tract infection]], [[Prostatitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| [[Secondary tumor deposits in vertebra]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Multiple sclerosis]], [[Pudendal nerve entrapment]], [[Spinal cord lesions]], [[Syringomyelia]], [[Transverse myelitis]], [[Tabes dorsalis]], [[Tumor of the spinal meninges]], [[Tumor of the spinal cord]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| [[Retroverted pregnancy]], [[Uterine fibroids]], [[Vaginal carcinoma]]
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [[Secondary tumor deposits in vertebra]], [[Tumor of the spinal meninges]], [[Urethral carcinoma]], [[Vaginal carcinoma ]], [[Prostatic cancer]]
|-
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
|bgcolor="Beige"| [[Amitriptyline]], [[Amoxapine]], [[Anticholinergics]], [[Nasal decongestants]], [[Norpramin]], [[Pamelor]], [[Sinequan]], [[Surmontil]], [[Tofranil]], [[Tricyclic antidepressants]], [[Vivactil ]]
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| [[Bashful bladder syndrome]], [[Shy bladder syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Multiple sclerosis]], [[Transverse myelitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| [[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]]
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}

=== Causes in Alphabetical Order ===

{{MultiCol}}
*[[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]]
{{ColBreak}}
*[[Recovery from general anesthesia]]
*[[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 ]]
{{EndMultiCol}}

==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 [http://www.nlm.nih.gov/medlineplus/ency/article/003425.htm urine volume] and to get urine for culture (a [http://www.nlm.nih.gov/medlineplus/ency/article/003752.htm 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]]).

==References==
{{Reflist|2}}

[[Category:Signs and symptoms]]
[[Category:Urology]]