Delayed Urination: Causes and Treatment Options

Q: Delayed Urination: Causes and Treatment Options

Hello： Medications can affect urination, and aging can also have an impact. <br>If urination affects your daily life, you should seek medical attention. <br>Wishing you good health.

It takes a while to urinate?

Hello Dr.
Du, it's me again.
I have another question.
About four to five months ago, I started noticing that it takes a little time for me to urinate, but not every time.
I visited a doctor at Shudian, and he mentioned that it might be due to the medications I am taking for mental health, such as Eslin and Mu Jing, which could affect my urination.
He prescribed two medications; I apologize for forgetting their names, but one is yellow and is used to treat non-obstructive urinary retention, and the other seems to be for treating male prostatitis.
He did not ask me to return for a follow-up, but later I lost the medications on the bus and did not go back for a check-up.
Recently, I have been experiencing particularly severe morning and nighttime urination issues, where I need to sit for a while before I can urinate, and the urine volume is not much.
Am I experiencing this because of my age, or is it indeed due to the effects of the medications, as the doctor at Shudian suggested?

Er Mao, 50~59 year old female. Ask Date: 2022/03/14

Dr. Du Shixi reply Urology

Hello: Medications can affect urination, and aging can also have an impact.
If urination affects your daily life, you should seek medical attention.
Wishing you good health.

Reply Date: 2022/03/14

More Info

Understanding delayed urination can be a complex issue, especially when it involves a combination of psychological factors, medication side effects, and potential underlying medical conditions. Based on your description, it seems that you have been experiencing significant urinary difficulties, including delayed urination, frequent urges, and a feeling of incomplete bladder emptying. These symptoms can be distressing and may impact your quality of life.

Causes of Delayed Urination:
1. Medication Side Effects: As you mentioned, medications such as escitalopram (Lexapro) and other psychiatric drugs can have side effects that affect urinary function. Antidepressants, particularly those that influence serotonin levels, can lead to urinary retention or difficulty initiating urination. This is due to their action on the central nervous system, which can alter the normal reflexes involved in urination.

2. Psychological Factors: Your history of pathological holding of urine due to anxiety about using public restrooms may have conditioned your bladder and urinary tract to respond differently. Chronic retention can lead to changes in bladder function, such as decreased sensitivity and increased residual urine volume, which can exacerbate the feeling of incomplete voiding.

3. Age-Related Changes: As men age, they may experience changes in prostate size and function, leading to conditions such as benign prostatic hyperplasia (BPH). This can cause urinary symptoms, including delayed urination, weak stream, and incomplete emptying.

4. Neurological Factors: Conditions affecting the nervous system can also impact bladder control. If there are any underlying neurological issues, they could contribute to your symptoms.

5. Bladder Dysfunction: Over time, chronic urinary retention can lead to bladder dysfunction, where the bladder muscles become less effective at contracting, leading to difficulties in initiating urination.

Treatment Options:
1. Medication Review: It is essential to review your current medications with your healthcare provider. They may consider adjusting your psychiatric medications or prescribing alternatives that have fewer urinary side effects. Medications like tamsulosin (Flomax) are often used to help relax the muscles around the prostate and bladder neck, making it easier to urinate.

2. Behavioral Therapy: Cognitive-behavioral therapy (CBT) or other forms of psychological support may help address the anxiety associated with urination in public spaces. This could potentially reduce the psychological barriers to normal urination.

3. Bladder Training: Engaging in bladder training techniques can help retrain your bladder to respond appropriately. This includes scheduled voiding and gradually increasing the time between urinations.

4. Pelvic Floor Exercises: Strengthening the pelvic floor muscles through exercises (like Kegel exercises) can improve bladder control and urinary function.

5. Urodynamic Studies: If symptoms persist, your doctor may recommend urodynamic studies to assess how well your bladder and urethra are functioning. This can help identify specific issues that may require targeted treatment.

6. Follow-Up Care: Regular follow-up with your healthcare provider is crucial. If you experience worsening symptoms or new issues, such as pain or blood in the urine, seek immediate medical attention.

In conclusion, delayed urination can stem from various factors, including medication side effects, psychological conditioning, and age-related changes. A comprehensive approach that includes medication management, behavioral therapy, and possibly further diagnostic testing will be essential in addressing your symptoms effectively. Always consult with your healthcare provider before making any changes to your treatment plan.

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