Experiencing Difficulty in Urinating

Difficulty in urinating is also known as urinary hesitancy. In this condition, passing urine in the normal way tends to be a problem and is sometimes painful. People experiencing this problem have to really force themselves to urinate. Some people may find that they feel an urgent need to urinate, yet when they actually do that, the amount of urine that flows out is very less. This condition can be uncomfortable and painful.

Another problem that some encounter is that their urinary stream becomes very weak. All these problems associated with difficulty in urination may result from a number of health conditions and illnesses.

▶ Urinary Blockage Caused Due to Conditions Like:

• Benign Prostatic Hyperplasia: This condition occurs when, the prostate becomes enlarged, squeezes the urethra, blocking the urine flow. This causes difficulty in urination. It mostly occurs in men over the age of 50 years.

• Bladder Stones: These are formed when minerals like magnesium and calcium crystallize due to dehydration. The urine flow gets blocked when the bladder stone enlarges. In some cases, there are multiple stones collected in the bladder, preventing the flow of urine.

• Tumors: A large prostate or bladder tumor can lead to blockage of the urethra. Most tumors are slow-growing; therefore, when the symptoms of urine hesitancy become apparent, one must consult a doctor and check for tumorous growth.

• Urethral Stricture: Narrowing of the urethra is called urethral stricture. This condition takes place when the walls of the urethra swell up due to bacterial or viral infection, or due to sexually transmitted diseases.

▶ Bladder Diverticulum: Pouches formed inside the bladder, which retain some quantity of urine are known as bladder diverticulum. These pouches do not empty out during urination. Bladder diverticulum is a condition that one can be born with or it may arise any time.

This condition is diagnosed with the use of X-rays (cystogram), passing a scope into the bladder through the urethra (cystoscopy) and also by conducting an ultrasound.

▶ Infection: Urinary tract infections can lead to difficulty in urination. Urinary tract infections may affect the upper or lower part of the urinary tract. One of the main causes of UTI is Escherichia coli, which is a rod-shaped bacterium.

▶ Medication: Medicines for allergies - fexofenadine (Allegra), diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton), cetirizine (Zyrtec); depression - imipramine (Tofranil), amitriptyline (Elavil, Endep), nortriptyline (Aventyl, Pamelor), doxepin (Novo-Doxepin, Sinequan); or anesthesia during surgery cause urinary hesitancy.

▶ Nerve Damage: Nerves that control the urine flow could get damaged due to infections of the brain or spinal cord, diabetes, stroke, accidents that injure the brain or spinal cord, multiple sclerosis, heavy metal poisoning, pelvic injury or trauma.

▶ Painful, frequent urination.
▶ Feeling of having a full bladder even after passing urine.
▶ Problems having an erection.
▶ Experiencing pain or pressure in the abdomen or penis while urination or having sex.
▶ Having pain or stiffness in abdomen, hips, inner thighs or lower back.
▶ Passing pink or red urine.

▶ Surgery: To remove blockages, tumors and even the prostate, surgery is essential. Sometimes, surgery is performed to reduce the size of the prostate or remove it completely. The name of this surgery is transurethral resection.

▶ Foley Catheter: A catheter is placed in the bladder to enable draining of the urine. This catheter is inserted through the urethra into the bladder, allowing the urine to drain into a collection bag. A foley catheter, is a flexible tube that has two separate lumens. These catheters are generally made of either silicone or natural rubber.

▶ Medicines: Alpha blockers, antibiotics, hormonal medicines, and 5- alpha-reductase inhibitors are prescribed depending on the type of urinary condition causing the problem.

▶ STDs: Sexually transmitted diseases like HIV, HPV, Syphilis, etc. can cause difficulty in passing urine.

▶ Cystocele: This condition is also known as anterior vaginal wall prolapse. It occurs when the wall of the vagina becomes weak, causing the bladder to bulge into the vagina.

▶ Kidney Stones: When kidney stones, due to their size or number block the urinary tract, the passing of urine becomes difficult and sometimes painful.

▶ Fibroids: Fibroids are non-cancerous tumors. If the size of the fibroid is large, it can cause problems in urinating.

▶ Pregnancy: Difficulty in urinating occurs when the uterus enlarges, and compresses the urethra in the process, especially if the uterus is in a retroverted position. This usually happens in the first trimester, and resolves on its own in later pregnancy.

▶ UTIs: Due to swelling of the urinary tract, during infection, women experience difficulty in urinating.

▶ Pain in the abdomen, groin, lower back, and thighs.
▶ Burning sensation while trying to urinate.
▶ Discharge from the vagina.
▶ Cramps in the lower abdomen.
▶ Frequent urination in small quantities.
▶ Pain while urinating.

▶ Urinary Catheterization: It is a medical procedure where a latex, polyurethane, or silicone tube is used to drain out urine from the bladder. Inserting a catheter in the urethra is the most basic method of catheterization for women.

▶ Vaginal Estrogen Therapy: When estrogen drops below the normal level, various health problems like vaginal dryness, burning, dyspareunia, bladder infections, etc. can occur. This treatment is performed on women that are going through menopause, as their bodies reduce or stop the production of estrogen.

▶ Cranberry Juice: Cranberry juice has certain compounds like quinic, malic and citric acids that are not broken down during digestion, and these compounds help in breaking down the bacterial manifestation in the urinary tract.

▶ Antibiotics like Sulfamethoxazole-trimethoprim (Bactrim, Septra), Amoxicillin (Amoxil, Augmentin), Nitrofurantoin (Furadantin, Macrodantin), Ampicillin, Ciprofloxacin (Cipro), Levofloxacin (Levaquin), etc. are prescribed to the patients.

▶ A person who finds it difficult to urinate, should keep a track and maintain a record of his/her urination pattern.
▶ Massaging the bladder area or putting some sort of light pressure on it, helps in stimulating urine flow.

▶ Drinking lots of water, at least 2-3 liters a day, will help in increasing urination.
▶ A home remedy to treat difficulty in urination is to apply some heat on the lower abdomen and near the pubic bone. Since bladder is located in this region, the heat will relax the muscles and help in urination.

▶ Avoid using public washrooms and toilets as most urine related infections are contracted there.
▶ Keep the pubic area clean.

Difficulty in urinating, in most cases, is gradually experienced by a person. That's why, it might take longer for him/he to consult a doctor regarding this health issue. However, if along with difficulty in urinating, a person has fever, back pain, vomiting, chills, blood in urine, extreme urgency to urinate, discharge from the vagina or penis, a doctor should be contacted without any delay.

Disclaimer: This story is for informative purposes only, and should not be used as a replacement for professional medical advice.