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You probably know that urinary hesitancy is a common problem for older women. But did you know that it’s also common throughout the life cycle? In fact, urinary hesitancy can affect both men and women of all ages.But what exactly is it and how do you know it’s a problem? The answer is simple, just listen to your body.

Urinary hesitancy
Urinary Hesitancy
Source: Medical News Today

What is Urinary Hesitancy?

All urinations are involuntary, but nasal hesitancy is a major exception. It occurs mostly when the urinary bladder is full.

Dr. Harry Oderberg, urologist and founder of OB Neurology.

Hesitancy is a common challenge for women, explaining one of the reasons that women are more apt to have urinary incontinence.

Types of hesitancy can be divided into three categories.

Dr. Robert Zarr, pediatrician and 30-year veteran of the faculty at NYU Langone Pediatric Urinary Sleep Medicine Center.
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Sternal hesitancy (also known as bladder lateralization) occurs when the nervous and muscular systems start to take on distinct roles during urination. When that happens, the bladder may try to lengthen to allow urine to flow out. Which can lead to reduced flow and even backing up. For example, if your autonomic nervous system senses that you’re about to pass water. It might attempt to force you to close your sphincter to stop the flow.

It’s not your conscious system at work here. Just the sympathetic system trying to help you control body function and hack into your autonomic nervous system.



If your sympathetic nervous system is trying to keep your body stable (i.e. stay warm) but your conscious mind doesn’t want to go with it, you might get urinary lateralization to help you “catch your breath” or remain calm.

This can happen when the autonomic nervous system levers up during sleep or when you start to feel very cold.


If this happens, your bladder may try to tighten as you try to begin urinating. Which can lead to a scrambled race to the bathroom, instead of natural daytime flow.


If you fall into the gynaecological (i.e. reproductive) category and experience more than one of the other hesitancy types. Zarr recommends asking your doctor about a urinalysis to see if your viscosity has changed. If it does, you may have a primary sleep disorder. That causes your body to involuntarily produce more than one of the viscosity tests suggests.

This is one of the most common causes of urinary hesitancy, since the causes can be quite simple, for example dehydration or medications.


In fact, the American Urological Association (AUA) estimates that it affects upwards of 450 million people around the world.


Although many people with urinary hesitancy are referred to as hypohydric, lack of blood flow during exercise, or hyperhidrosis, does actually cause dry or tissue-like urine.

In both men and women, under-stimulated muscle tissue pulls water toward your organs, causing a build up of water in your bladder. But it’s what happens next that may create that build up.

As your muscles contract and tense to contract your bladder, pressure inside the bladder builds up causing tissue to consolidate, says Dr. William Rossi, urologist and founder of The UrologyPhysiotherapy in Bellmore, NY. That causes centrifugal (lateral) urine flow, and often causes the muscles to become so tight that interruption to the flow is uncomfortable.

You may also notice yellowing or bleaching of the urinal lining.

Which is typically most noticeable in patients who have repeatedly experienced urinary issues.

Dr. Gautam Banshik, urologist and founder of BHU Club.


Although these two symptoms appear to be separate, urology refers to them as part of the same problem. “The reasoning behind this is that when muscle contractions cause water retention and the urine base is strained, that water mistakenly moves backwards and is excreted backward in the esophagus,” explains Dr. Kansagra Pandya, urology fellow and preventive medicine physician at The Ohio State University Wexner Medical Center.

This can cause swelling and tenderness in the neck, vocal cords, tongue, throat, larynx and chest. Over time, it can even cause loss of hair, says Pandya.

What’s more, women who have this condition may have episodes of urinary retention and pain in their lower abdomen.

The cause of this on both men and women would be if the muscle imbalances and is not able to maintain a proper posture and function properly.

Dr. Kansagra Pandya


The first step to treating either form of hypohydration or hyperhidrosis is to identify how the problem started. Dr. Banshik suggests first evaluating symptoms in your general health, but makes a strong case that exercise has a lot to do with it.

In both, the symptoms are explained by well-defined symptoms of hypertension in both genders, and incontinence. Exercise is a very good line of defense [for urologic problems]. The most obvious sign is dehydration.

Dr. Banshik

Next, you should schedule an appointment with your physician, who may be able to work with you to develop a plan to track your water intake and test for constipation.

Certain medical conditions and medications can cause the issue, while other issues like thyroid problems and low blood pressure can contribute to it as well.

What is Urologic Urgency?

In a perfect world, all pee would align nicely in the bladder when you stood up. But until the bladder can function properly, there’s some hesitance and spasm that happens. This is sometimes referred to as urologic urgency or urinary urgency, and it occurs most often in people with urinary problems or low blood pressure.

Poor bladder control can also result from structural or medication issues, such as diabetes or heart problems.

Melody Levine, RD, co-author of “Losing Weight with Riddles and Riddles: Interfering With Blast Renovation.” published by Houghton Mifflin Harcourt in 2018.

While you might be frustrated by the problem, medical professionals tend to advocate for people who may lose control of urination at some point in their life.

These problems have the potential to greatly impair your quality of life, including your sexual function.


Unlike low blood pressure, which is a more accurate indicator of pressure in the arteries, urologic hesitancy is a more subjective issue related to pressure in the bladder itself, Levine adds. There’s no set number of millimeters of water that needs to flow out to fill the bladder, and all fluids can enter the bladder at the same time.

Before you stand up, your body releases some pressure, and urine flows. As you stand up, your body momentarily loses control of its bladder drive as it struggles to generate enough pressure to force all that puppy out, all the while letting go of whatever pee was stored in there.

In a study published online in the Journal of Clinical Endocrinology & Metabolism, researchers found that people with urologic urgency saw 44% more reflux symptoms that is, the urge to pee while having indigestion than people without urgency. Some of the reasons the pressure builds include:

  • Overproduction of stomach acid
  • Diminished muscle tone, leading to weak, indecisive spasms
  • Excessive exercise and dehydration
  • Chronic blood pressure medications such as medication used to treat high blood pressure
  • Lower cardiac function due to diseases like poor circulation and heart failure

Some experts think that while there are some signs of urgency, urine loss isn’t a good way to diagnose these conditions.

About half of the time, what people have is chronic low blood pressure and weakness of the bladder. That’s not a good diagnosis.


Because one may resolve quickly while the other may take months or even years to improve.

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A lot of work has gone into bringing you this post. We hope you found it interesting and informative. If you have a question, please ask it in the comments at the foot of this post.

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5 Things You Didn’t Know About Urinary Hesitancy

Stephen Walker is a blogger who has been living with Multiple Sclerosis or MS since 1994. He devotes a lot of time to researching this dreadful autoimmune disease, looking for answers and possible treatments.

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