Difficulty Urinating Explained: Why and What to Do

There are many health issues that cause difficulty urinating. These issues can be as significant and long-lasting as multiple sclerosis to simple and curable issues such as a urinary tract infection, otherwise known as UTI. When a person has trouble peeing, it can be very uncomfortable and, sometimes, very painful. Difficulty urinating, also known as urinary retention, can happen suddenly, but may require emergency treatment.

Causes of Difficulty Urinating

There are many potential causes for trouble peeing. Some causes can affect anyone and some causes are gender specific. Here are the details:

For Men

Difficulty urinating is more common in men than women. One study suggests that this medical issue may be up to 10 times more common in men than women! Those most likely to have an incidence of acute urinary retention are men over the age of 70. The following are some reasons:

  • Enlarged prostate – most common cause of urinary retention;
  • Phimosis – a penile dysfunction which occurs when the foreskin is unable to retract. This dysfunction occurs inuncircumcised men and children who are born with a tight foreskin;
  • Paraphimosis – a penile dysfunction which occurs when the foreskin is retracted and will not return to its original position. This condition is very uncommon;
  • Other causes for men experiencing difficulty urinating include prostate cancer, penile trauma, penile fracture and penile laceration.

For Women

  • Uterine prolapseoccurs when the uterine muscles or ligaments become weak and can no longer hold the weight of the uterus. The uterus then falls out of its normal position and can even fall as far as into the vaginal canal, causing hard to pee.
  • Cystocele, also called Anterior Prolapse, occurs when the bladder is no longer held in place by the supportive tissue between the bladder and the vagina and bulges out of place, usually into the vagina, causing issues like difficulty urinating and even bladder infections.
  • Rectocele – hernia inside the vagina because of a tear in the divider between the rectum and the vagina. It also known as Posterior Prolapse and usually occurs because of childbirth or a hysterectomy. Also known as Posterior Prolapse.
  • Gynaecological malignancy – cancer of the reproductive system in women.
  • Fowler’s syndrome occurs when the bladder’s sphincter muscles will not relax.
  • Uterine fibroid – growths in the uterine during pregnancy, causing frequent urinating or difficulty emptying your bladder.
  • Other pregnant related issues, like retroverted gravid uterus when uterus is tipped or tilted during pregnancy, and postpartum when an instrument is used to deliver, when labor is prolonged or when caesarean section is performed.

For Both Men and Women

  • Bladder cancer
  • Chronic constipation
  • Gastrointestinal cancer
  • Retroperitoneal cancer
  • Bladder stones
  • Blockage of bladder due to a growth
  • Narrowing of the urethra
  • Diabetes nerve damage
  • Stroke damage
  • Spinal cord injury
  • Narcotics
  • Antihistamines
  • Antidepressants
  • Alcohol
  • Bladder diverticula – when your bladder does not empty correctly and causes pockets of urine to form and stay in your bladder

Diagnosis of Difficulty Urinating

There are ways of diagnosing urinary retention, including a physical exam and a test for the amount of urine remaining in the bladder after the patient pees.There are also a few medical tests that can be performed to diagnose urinary retention.

  • Cystoscopy to look for structure issues in the bladder or possible stones which may be blocking the urethra.
  • CT scans to look for stones, tumors, injuries, cysts, or the possibility of a UTI.
  • Uroflowmetry which tests the flow of urine and the speed at which it flows.
  • Pressure flow study is a study which measures the amount of urine needed inside the bladder before the patient realizes he or she has to urinate, or before the bladder will allow the patient to release urine.
  • Video urodynamics is a process in which an x-ray is used to view all aspects of the bladder, including its functions and function ability.
  • Electromyography uses sensors to record muscle and nerve ability and activity.

How to Deal With Difficulty Urinating

The main treatment, of course, is emptying the bladder by catheterization at the doctor's. Occasionally, patients are required to continue to catheterize at home to ensure bladder is always allowed to be emptied.

Other possible treatments include dilation of the urethra, inserting a stent into the urethra, and for men treatments may be medications given for prostate issues.

Surgery is also an option. There are different surgery options depending on the underlying cause of the problem. Some of these surgeries include prostate surgeries, urethral repair surgery, repair surgery for bladder or rectum, and surgeries to remove tumors. Before accepting any surgery, be sure to have a good talk to your doctor to find out which procedure suits you best, the risks, benefits and so on.

Tips for Trouble Peeing

For both men and women, better nutrition and more exercise can help keep your bowels moving, thus helping prevent difficulty urinating caused by constipation.

For men, some over-the-counter medications should be avoided if he has already been diagnosed with certain prostate issues such as benign prostatic hyperplasia. Talk to your doctor or pharmacist if this applies to you.

For women, Kegal exercises and other pelvic exercises can keep the bladder and the surrounding muscles (including the pelvic muscles) in good working order.

Long-term trouble peeing is generally the cause for acute urinary retention, which can lead to complete inability to urinate. Acute urinary retention is very dangerous and requires immediate emergency care!If you believe you or someone you care for are having issues of difficulty urinating, contact your doctor and get things fixed.