Difficulty in Urinating With Weak Flow

Q: I am a 46 years old male. While passing urine, I am having problem that the urine comes slow and the amount of urine is less.
– By Deepak saha

Reply:

Sounds like there is some obstruction in the passage of passing urine.

Though, without a physical exam, it’s not possible to say what is the exact cause of your symptoms, we’ll let you know the possible reasons which give such symptoms in your age.

Reasons of Slow and Less Urination

This symptom suggests that there is some kind of partial obstruction in the passage of urine. Urine is stored in the urinary bladder. It gets collected there and causes stretching of the muscular bladder walls. This stretch produces an urge to urinate.

The urine then flows out of the bladder through a tube called urethra. Just below the bladder, there is a small gland called prostate. This gland surrounds the upper portion of the urethra. Any inflammation or enlargement of the prostate can slow down the stream of urine.

Physiological Enlargement of Prostate

It can be a normal physiologic enlargement. This gland is very small in childhood. The first growth spurt it experiences is during puberty, when it suddenly grows up to about 20g in size. This is essential, as the gland produces secretions which are essential for the nourishment of the sperms.

The second growth spurt occurs somewhere during mid 30’s. The reason of this growth is unclear. The gland now attains a size of about 40g. A person may feel symptoms of obstruction for sometime. Gradually the urethra adjusts with the new size of prostate and the symptoms wean off. No medical intervention is required. This could be the reason in your case.

Prostate Infection

Prostatic enlargement may be there if the gland is inflamed due to infection. The condition is called prostatitis. Here, some associated symptoms are usually present. They include:

  • Fever
  • Dull pain in groin or back
  • Urgency to urinate

If you have any of the following symptoms, you will require an antibiotic course.

Urinary Tract Infection

Another possible reason which slows down the stream of urine is UTI (urinary tract infection). There may be some bug in the urethra (lower UTI) or the bladder. Here also, the patient usually has other associated symptom like:

  • Fever
  • Pain or burning during urination
  • Groin or back pain
  • Urine may be cloudy in appearance
  • Blood or pus in urine
  • Urgency to urinate

If any of the above symptoms are present, you will need an antibiotic course. It is better not to delay treatment and be prompt. This is to prevent the infection from climbing up the urinary tract.

How to Diagnose?

You need further evaluation by a doctor to get a diagnosis made.

The doctor will first examine you. He may do a per rectal exam (inserting finger through the anal opening) to see if there is any enlargement of the prostate.

Following investigations may be required:

  • Ultrasound bladder
  • Urine flow studies
  • Urine examination with culture

Accordingly, treatment may begin. You are welcome to ask any further questions.

Take Care,

Buddy M.D.

Medical Advice (Q&As) on “Slow Flow of Urine Stream and Decreased Amount in Males

  1. Gautam Mishra

    Dear doctor, I have grade 2 prostatitis. Age 47 along with recurrent UTI, have been having antibiotics in and out.
    Plus urimax D for more than 8 months with no relief plus I have got chronic amebiasis and piles. I always have burning sensation in the rectum. One doctor has suggested TURP. Will it help?

    Reply
    1. Buddy M.D. Post author

      Though chronic prostatitis involves the enlargement of the prostate gland, TURP is usually not done.

      Only in selected patients, the procedure is considered, to remove the nidus of infection. The patients are the ones which have prostatic stones and a long standing infection in the prostate.

      Stones are visible in transrectal ultrasonograms.

      Reply

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