Difficulty urinating includes a slow start, a weak or interrupted stream, straining, dribbling at the end and a feeling that the bladder has not emptied. These symptoms are more common in men as they get older, but they can occur in women too.
Medically reviewed by Prof. Dr. Samir Ahmed Al-Samarrai, consultant urologist. Last reviewed:
Common causes
- Benign prostate enlargement, the most common cause in men after middle age.
- Urethral stricture after infection, injury or a previous catheter.
- Prostatitis.
- A weak bladder muscle or nerve problems, as in diabetes or neurological disease.
- Some medicines, and severe constipation.
- Pelvic organ prolapse in women.
Diagnosis
- Clinical examination, including a prostate examination in men.
- A symptom questionnaire and urine test.
- Urine flow measurement and ultrasound to measure urine left in the bladder and prostate size.
- PSA test in men depending on age and history, and cystoscopy when needed.
Treatment
Treatment depends on the cause and how severe the symptoms are: monitoring and lifestyle changes for mild cases, medicines that relax the prostate and bladder neck or shrink the prostate, and surgical or endoscopic treatment when needed, such as treating a urethral stricture or removing part of the prostate. Read more in the four-part review on benign prostatic enlargement.
When to call an ambulance
Call 998 or go to the nearest emergency department if: you cannot pass urine at all and have severe pain and swelling in the lower abdomen, or difficulty urinating comes with high fever and shivering.
Related topics
Frequently asked questions
What is urinary retention?
Being unable to empty the bladder. Acute retention starts suddenly with pain and swelling in the lower abdomen; it is an emergency that needs a catheter to drain the bladder, then treatment of the cause.
Does a weak stream in a man always mean an enlarged prostate?
Prostate enlargement is the most common cause after middle age, but urethral stricture, a weak bladder muscle and some medicines can cause similar symptoms, so an examination is needed.
Can medicines cause difficulty passing urine?
Yes, such as some allergy medicines, decongestants and some antidepressants and bladder medicines. Do not stop any medicine without asking your doctor.
Book an examination to find the cause
Prof. Al-Samarrai and Dr. Amer Mousa find the cause of urinary symptoms with the right examination and tests at Prof. Al-Samarrai Medical Center in Dubai Healthcare City.
This information is for health education and does not replace a medical examination. See our medical content policy.