Difficulty starting or maintaining a urinary stream is called urinary hesitancy.

Urinary hesitancy affects people of all ages and occurs in both sexes, but it is most common in older men with enlarged prostate glands.

Urinary hesitancy usually comes on gradually. It sometimes goes unnoticed until urinary retention (complete inability to urinate) produces distention and discomfort in the bladder.

Almost all older men have some degree of difficulty in starting urination, dribbling, or decreased force of their urinary stream.

Urinary hesitancy can be caused by:

• Benign prostatic hyperplasia (enlarged prostate)
• Urinary tract infection, especially if chronic and recurrent
• Prostatitis (inflammation or infection of the prostate gland)
• Drugs (some cold remedies, some nasal decongestants, tricyclic antidepressants, and anticholinergic drugs which may be used for incontinence)
• Shy or bashful bladder syndrome (inability to urinate when another person is in the room)
• Neurologic disorders
• Recent surgery (postoperative retention)