Poor urine flow

Causes of the weak urine stream in men

A benign, enlarged prostate is one common cause of slow urine flow in men. It is the most common cause in older men. In addition, young males may experience an inflammation of the prostate called prostatitis. In these situations, the prostate increases its volume and obstructs the urethra. Consequently, urination becomes complicated and slow.

Frequent urination and poor ejaculation often accompany poor urinary stream in prostate diseases.

Causes of the weak urine stream in women

Poor urinary stream, or hesitancy, is less frequent in women. This symptom is most likely to develop after childbirth or postpartum and is related to trauma to the bladder’s nerves. The risk factors are:

• the prolonged second stage of labor;
• episiotomy;
• perineal tearing;
• use of forceps or vacuum during childbirth;
• epidural use;
• baby weighing over 4000 grams.

Urinary tract infections and herpes genitalis are other possible causes of low urine flow and hesitancy in women.

Poor urine flow during pregnancy

During pregnancy, you are more likely to have frequent urination rather than poor urinary flow. Despite some beliefs, we cannot consider poor urine flow as a sign of early pregnancy.

Weak urine stream in postmenopausal

Postmenopausal women may have a weak urinary stream because of the under-activity of the bladder muscle. The bladder contracts slower, and the urine flow is weak.

Causes of poor urinary flow after surgery

Immediate after cystoscopy, endoscopic prostate resection (TURP), or prostate surgery (Radical prostatectomy), reduced urine flow is typical, and it is due to inflammation and swelling of the urethra after the surgical trauma. The obstruction is usually transitory. After days, the urine flow will improve with inflammation recovery. If the poor urinary stream occurs after weeks to a few months, most likely, the obstruction is due to a urethral scar (urethral stricture), and we have to consider the further procedure.

Poor urinary flow after other surgeries, like inguinal hernia surgery, may be related to transitory bladder hypo-function because of epidural anesthesia.

Other pelvis surgeries like hysterectomy or low anterior colon resection may be the reason for hesitancy and low urinary flow. It may be due to accidental nerve damage during the operation.

In all cases, the patient needs bladder catheterization (temporary or permanent) to void the bladder and preserve kidney function.

Alcohol and weak urinary flow

Alcohol causes dilatation of the veins. The prostate and the bladder neck are widely surrounded by large veins draining the blood from those organs. The more the veins dilate, the less efficient the blood drainage from the prostate and the bladder neck. It results in blood congestion, prostate swelling, and contraction of the bladder and neck. Consequently, the urinary flow will be weak.

Weak urine flow with other symptoms

Weak urinary flow may come not alone. It may occur with painful urination and a burning sensation in the case of UTI.

When weak urine flow comes with frequent urination, it is a sign of lower urinary tract obstruction like prostate enlargement or urethral stricture. In these cases, there may also be poor ejaculation.

If a stone gets stuck in the urethra, the urine flow will be in scattered and possibly painful drops.

Fever and poor urine stream are always urgent and sometimes a real emergency.

Poor urine flow and diabetes

One of the complications of diabetes is bladder underactivity related to damage to its nerves. The nerves innervating the bladder are commonly affected over the years, especially in uncontrolled diabetes. Consequently, the nerve signal for contraction is less efficient, and the bladder contraction is weak. However, diabetes reduces the muscle in the bladder wall that contracts less efficiently. All these situations are caused by weak urine flow.

How to cure poor urine flow

Since there are several reasons for weak urine flow, we cannot treat it without a correct diagnosis. The urologist will guide you through the diagnostic steps, which usually include the following:

• urine analysis;
• blood work;
• US scan;
• Uroflowmetry;
• Cysto-urethrography;
• Urethra-cystoscopy.

Emergency

A weak urine stream, mainly if associated with other symptoms (above all, fever), is always a good reason to see a doctor urgently.

Home remedies

I strongly contraindicate home remedies for weak urine stream without seeing a doctor first.

External resources

European Association of Urology