Weak Stream symptoms, causes and treatment

The difficulty of starting or maintaining a urine stream is called a weak stream or urinary hesitancy.  Weak stream or urinary hesitancy can occur in both men and women at any age, although the condition is most common in older men with an enlarged prostate gland. The condition develops slowly over time.

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 It may remain unnoticed until you are unable to urinate anymore, a condition known as urinary retention, which causes swelling and discomfort in the bladder.

Weak stream or urinary hesitancy may, in some cases, lead to urinary retention. This occurs when you are unable to urinate, which can be a very serious condition.

Urinary hesitancy or weak stream can be the result of a variety of medical conditions. If you experience this condition, make sure to schedule an appointment with your doctor who can pinpoint the cause of your condition and offer possible treatment options.

Weak stream or urinary hesitancy should not be taken for granted, especially if the condition is recurring or is getting worse each time it happens. It could develop to something more serious if not properly addressed or treated or it could be a symptom of a more serious underlying cause.

Urination is an important function of the body that should be performed on a regular basis.  Failure to do so may lead to serious health problems.

Causes of A Weak Stream

There are plenty of possible reasons behind a weak stream of urinary hesitancy. Some of the causes affect both men and women, while others affect only one group.

The following are some of the common causes of a weak stream or urinary hesitancy:

  • Anesthesia from surgery
  • Nerve damage due to strokes, accidents, diabetes, or brain damage
  • Urinary tract infections
  • Surgery on any part of the urinary system
  • Kidney or bladder stones
  • Sexually transmitted infections
  • Medications, such as decongestants
  • Cancerous tumor causing urinary blockage
  • Psychological conditions
  • Bladder muscle disorders
  • Voiding dysfunction

Nervous system disorders and nerve damage

Diseased or damaged nerves can interfere with the flow of urine. Nerves may be damaged by:

  • Stroke
  • Accidents
  • Diabetes
  • Childbirth
  • Brain or spinal cord infections

Multiple sclerosis and other nervous system disorders can also result in nerve damage.


Anesthesia administered during the surgery may impair some of your nerves. This can result in urinary hesitancy afterward. Surgery on the kidney, bladder, or urethra can create scar tissue that may constrict the urethra, causing urinary hesitancy or a weak stream.


Prostatitis is a common problem among men. It is the inflammation of the prostate gland that is often caused by infection. It can lead to the swelling of the prostate, which puts pressure on the urethra, resulting in a weak stream.

Urinary tract infections and sexually transmitted infections may lead to problems with urinary hesitancy in both men and women.

Shy bladder syndrome

In rare cases, weak stream or urinary hesitancy could be a sign of the psychological condition, known as shy bladder syndrome. Feeling uncomfortable about urinating in the presence of other people may make it hard for you to urinate in certain situations.

Common causes for men

Among men, one of the most common causes of urinary hesitancy is a benign, enlarged prostate. While this is common among older men, this condition may also affect younger men.

The prostate is a gland in men. It surrounds the urethra. The urethra is a tube that transports urine out of the body. There are times when the prostate becomes enlarged, putting pressure on the urethra. The increased pressure may make it difficult for a man to start or maintain a urine stream.

Men may also experience an inflammation of the prostate, a condition called prostatitis. Prostatitis is often caused by an infection. The inflammation puts undue pressure on the surrounding the urethra, which makes urinating very difficult.

Common causes for women

The likelihood of developing a weak stream or urinary hesitancy is lower in women than men. Usually, women develop a weak stream during pregnancy and immediately after birth.

Women are more prone to develop a weak stream or urinary hesitancy after childbirth when they also experience the following:

  • Episiotomy
  • The prolonged second stage of labor
  • Perineal tearing
  • Epidural use
  • Use of forceps or vacuum during childbirth
  • Baby weighing over 4000 grams

Urinary hesitancy among women is quite common after childbirth because of the trauma to the nerves that surround the urinary tract and the bladder.

Proper postpartum bladder care, such as voiding the bladder at least once every 6 hours can help prevent and relieve a weak stream or urinary hesitancy after childbirth.

Urinary tract infections are another common cause of urinary hesitancy in women.

Complications of a weak stream or urinary hesitancy

Even when there is a non-severe case of urinary hesitancy, ignoring your symptoms of weak urine flow or trouble starting urination may cause the condition to get worse. Eventually, the condition may lead to urinary retention, which is when a person cannot empty his bladder completely.

A complete or sudden inability to urinate is a serious condition that requires urgent medical attention. It may lead to serious health problems when not treated on time.

A person experiencing urinary hesitation must look for any signs of infection, such as pain or fever.

Diagnosis and Treatment


Your doctor will diagnose the underlying cause of your urinary hesitancy or other urination problems. He will likely ask for your medical history. He will want to know:

  • How long have you been experiencing urinary hesitancy
  • If your urine flow is weak
  • If it develops gradually or suddenly
  • If there’s anything that seems to relieve or worsen your symptoms

Your doctor may also inquire about the other symptoms that you might have experienced. Be sure to inform your doctor about your other medical conditions that have been diagnosed and the medications and supplements that you are currently taking.

Your order may also order one or more tests that will help him determine the cause of your symptoms such as urinalysis.

The doctor may ask for the swabbing of the inside of your urethra or insert a small flexible tube – a catheter – into your urethra to allow him to collect a sample of urine directly from your bladder.

Your doctor may also conduct one or more of the following urodynamic studies:

  • Pressure flow testing – It uses a catheter to measure pressure in the bladder, which will be compared to the flow rate during urination.
  • Uroflowmetry – The test measures the volume and flow rate of urine expelled while you are emptying your bladder.
  • Video urodynamic testing – It involves the use of a special fluid placed via a catheter into your bladder to create contrast imaging during filling and emptying of the bladder.

A doctor may conduct a rectal prostate exam on a male patient. The doctor may also create an image of the prostate using ultrasound or other imaging technology.


The treatment of urinary hesitancy depends on the underlying causes.

Some standard treatments for urinary hesitancy include:

  • Medicines for enlarged prostate
  • Antibiotics for infections
  • Procedures to dilate the urethra
  • Surgery to relieve a prostate blockage
  • Removal of scar tissue within the urethra

There are steps that a person may take at home to help ease the symptoms.

Home remedies for urinary hesitancy

There are many remedies that a person with urinary hesitancy can do at home that will alleviate the condition. The steps require very minimal effort and may be used alongside medical dare.

Some of the home remedies for urinary hesitancy include:

  • Using a heating pad or hot water bottle on the abdomen
  • Taking a warm shower or bath
  • Massaging the bladder era
  • Keeping a record of urination patterns to identify the triggers

What are the normal conditions

Average urine flow is based on the age and sex of a person. Typically, urine flow runs from 10 ml to 21 ml per second. Among women, the normal range is closer to 15 ml to 18 ml per person. A low or low flow of urinating rate could suggest there is an obstruction at the bladder neck or in the urethra, a weak bladder, or an enlarged prostate.

Risk of Having a Weak Stream

Males are more likely than females to have urinary hesitation due to prostate issues and partial blockages of the urethra. Other risk factors include urinary tract infections, the use of certain medications such as antihistamines and anticholinergic, and some decongestants.

Among women, the risk of having urinary hesitancy is higher during pregnancy and after giving birth.

When to Seek Medical Attention

If you experience recurring or persistent urinary hesitancy, you should see your doctor. Your doctor can help you determine the cause of your condition. He will recommend treatment that will help you relieve your symptoms.

There are instances when urinary hesitancy could be a sign of an emergency medical condition. You should seek immediate medical help if you have trouble urinating together with:

  • Vomiting
  • Shaking
  • Fever
  • Chills
  • Low back pain

You should go to the nearest emergency department if you cannot urinate at all. This condition is known as urinary retention. The condition can turn serious if not treated quickly enough.