Home Care:

• Monitor, record, and report your urination patterns to your doctor.
• Apply heat to your lower abdomen (below your belly button and above the pubic bone). This is where the bladder lies. The heat relaxes muscles and aids urination.
• Massage or place light pressure over your bladder to stimulate emptying.
• Drink plenty of fluid
• For infections, antibiotics from your doctor will be needed. Symptoms that suggest a possible infection include burning or pain with urination, frequent urination, cloudy urine, and a sense of urgency (strong, sudden urge to urinate).
• Pay close attention to any medicines or supplements you take.

Call your health care provider if:

If you have not been evaluated for this problem previously, you should call your doctor for urinary hesitancy, dribbling, or weak urine stream.

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

What to expect at your health care provider's office:

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).