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Urinary Hesitating, Straining, and Dribbling

By

Geetha Maddukuri

, MD, Saint Louis University

Last full review/revision May 2021| Content last modified May 2021
Click here for the Professional Version

A hesitating start when urinating, a need to strain, a weak and trickling stream of urine, and dribbling at the end of urination are common symptoms of a partially obstructed urethra. In men, these symptoms are caused most commonly by an enlarged prostate Benign Prostatic Hyperplasia (BPH) Benign prostatic hyperplasia (BPH) is a noncancerous (benign) enlargement of the prostate gland that can make urination difficult. The prostate gland enlarges as men age. Men may have difficulty... read more that compresses the urethra and less often by a narrowing (stricture) of the urethra Urethral Stricture A urethral stricture is scarring that narrows the urethra. A urethral stricture may be Present from birth Develop after an infection or injury A urethral stricture most commonly results from... read more . Similar symptoms in a boy may mean that he was born with an abnormally narrow urethra or has a urethra with an abnormally narrow external opening. The opening may also be abnormally narrow in women.

A doctor examines the prostate by inserting a gloved, lubricated finger into the man’s rectum (digital rectal examination). If the prostate is enlarged, a blood test to measure the level of prostate-specific antigen (PSA) may be done. Sometimes ultrasonography of the prostate is also done. If a urethral stricture is suspected, the doctor may insert a flexible viewing tube into the bladder (cystoscopy Cystoscopy A doctor can diagnose some disorders of the bladder and urethra (for example, bladder tumors, stones in the bladder, benign prostatic enlargement) by looking through a flexible viewing tube... read more ).

To treat an enlarged prostate, doctors can use drugs or surgery. To treat a urethral stricture in a man, doctors may insert a catheter into the bladder through the penis and dilate (stretch) the urethra. It may be necessary to insert a hollow tube to hold the urethra open (a stent). Surgeons may rebuild the urethra or use other surgical treatments.

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