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Urinary problems (micturition difficulties): Problems with urination

Urinary problems may be caused by physiological factors, such as age, anatomy and hormonal levels. Micturition problems are also caused by a (neurological) disorder, an infection and the use of alcohol or medication. Micturition difficulties such as frequent urination, dribbling and urination at night are sometimes very annoying for the patient and he may experience a lot of discomfort. The urologist notes the symptoms, examines the patient and performs additional tests if necessary. In this way he treats problems with urination. If necessary, the doctor also treats the underlying cause.

  • Urination at night: Nocturia
  • Acute retention
  • Difficult start
  • Dribbling: post micturition dribbling (PMD)
  • Intermittent urine stream (micturition flow)
  • Sudden and urgent waters: Urinary urgency/urinary urgency
  • Frequent urination: Pollakiuria
  • Little urination
  • Weak pee stream


Urination at night: Nocturia

With nocturia, a patient gets up at least twice a night to urinate. This happens in cases of kidney disease, heart insufficiency, varices (varicose veins) and paralysis of the lower limbs. This symptom is also regularly visible during menopause and pregnancy. In addition, some medications lead to nighttime urination. Physiologically, nocturia occurs when the patient drinks a lot in the evening.

Acute retention

In case of acute retention, the patient is suddenly no longer able to empty the bladder. He experiences intense and often painful urges to urinate. Various causes are known for this problem, such as bladder obstruction (blockage of the bladder), a neurological problem or swelling of the bladder (due to urination procrastination). Urinary retention damages the bladder and then leads to chronic renal failure.

Difficult start

When a drain becomes blocked, difficulty starting urination is often the first symptom. The patient often applies pressure to the abdomen to initiate voiding.

Dribbling: post micturition dribbling (PMD)

If urine remains in the urethra, the patient will dribble. This is due to a narrowing of the urethra (urethral stenosis), weakened pelvic floor muscles due to prostate problems, a bulge in the urethra, an enlarged prostate or a difficult urethra due to tight underwear, for example. Radiotherapy and surgical procedures may also lead to dripping.

Intermittent urine stream (micturition flow)

Sometimes a urine stream suddenly stops and then restarts a little later. This occurs, for example, with a bladder stone (hard accumulations of minerals in the bladder) that rolls in front of the bladder neck. The patient experiences a lot of pain. Another obstruction (blockage) may also cause an interrupted micturition flow.

Sudden and urgent waters: Urinary urgency/urinary urgency

The patient must urinate suddenly and urgently in the event of urinary urgency. The feeling of having to pee is irresistible. The bladder is overactive or irritated. If the patient is late to the toilet, this is a case of urgency incontinence.

Frequent urination: Pollakiuria

In pollakiuria, toddlers, children and adults urinate abnormally or frequently during the day (>8 times). Sometimes patients even need to urinate every five or ten minutes. Frequent urination is more common in boys than girls, and preschoolers and children are also affected more often than adults.Pollack isuria happens in these conditions:

  • a smaller boss
  • a residual urine residue
  • a partial obstruction (blockage) due to an enlarged prostate
  • inflammation of the bladder wall (due to a tumor, foreign body or infection)
  • scarring of the bladder wall (due to radiotherapy, bladder infection (interstitial cystitis), tuberculosis)
  • an overactive bladder
  • stress
  • Urinary incontinence: Some female patients with incontinence want to urinate very often because they try to prevent urine leakage in this way.

The treatment depends on the cause.

Little urination

The patient only urinates once or twice a day. This is quite common in patients on kidney dialysis. Sometimes this is out of habit by postponing a visit to the toilet because certain toilets are dirty at school or work, for example. As a result, the patient develops a residual and a very large bladder capacity.

Weak pee stream

When a blockage of the urethra occurs, the bladder muscle contracts with more force. When this contraction is reduced, weakness of the urine stream occurs. The weak urine stream also occurs without urethral obstruction. The weak pee stream is not always easy to assess; certainly not when this occurs gradually.

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  • Urinary urgency: Urgent, uncontrollable urge to urinate
  • Dysuria: Pain or burning during urination/urination
  • Urinary retention: Inability to empty the bladder (completely).
  • Pollakiuria (frequent urination): Causes of frequent urination
  • Polyuria: Large amounts of urination (excessive urination)