Q. I have low urine flow with hesitancy. Please suggest treatment options.

Answered by
Dr. Samer S J Altawil
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 25, 2020

Hello doctor,

I am suffering from poor urine flow and hesitancy. My USG and KFT are normal. I have attached the reports. What is the issue, and what are the treatment options?



Welcome to

I believe you have enlarged prostate causing obstruction to your flow. The size of prostate does not matter rather the shape of prostate is more important and the anatomy of prostate is well seen on the flexible cystoscopy if facility is available. You have mild symptoms of enlarged prostate.

Best is to do a serum PSA and start the tablet Tamsulosine 0.4 mg once at night. Follow up with blood test and we see how it goes. Medication will start acting after three days

I could see your reports of uroflowmetery, UDS and uss scan. All investigations showed that your bladder pressure is normal but flow is weak this indicates obstruction. After the age of 50 years normal prostate becomes occlusive but either its shape or its fibromuscular components this leads to reduced urine flow. With normal prostate size it is difficult to diagnose the cause of obstruction whether it is a median lobe of prostate causing it or a stricture in the urethra some where. Therefore I do a flexible cystoscopy for all my patients who got normal sized prostate with poor flow. Since the Q max in the uroflow is 10 ml per second then the obstruction is not really bad and you can use medications of it. As I mentioned you can take tablet Tamsulosine 0.4 mg once daily before bed time.

All patients above years of age complaining of urinary symptoms should go for blood test called PSA to role out prostate cancer. Therefore follow up with PSA and result of tablet treatment is indicated. If tablet is working well and PSA is normal then we will continue with the treatment. If you still have urinary symptoms and you are not satisfied with the medical treatment then flexible cystoscopy should be done before deciding on surgical treatment. Surgical treatment have many options like microwave therapy, fine needle ablation of prostate, TUNA, urolift, TURP or laser prostatectomy. Those surgical options will discussed later for all patients who failed medications and have occlusive prostate.

Was this answer helpful?


Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Related Questions:
Is an ER visit necessary for high creatinine and decreased urine output?

.. of diabetes, hypertension and chemotherapy all have contributed to the raised creatinine level. If you have urine output less than 500 ml persistently, then you may need help early. If you develop breathlessness, severe cough, fever or f...   Read full

What could be done to cure UTI causing difficulty in urination?

.. is common in young married women. You had UTI and it was treated with antibiotics, causing no growth on culture. Only thing of note is draining 400 ml through a catheter, usually, retention is not common. You should not hold urine for long. Never ...   Read full

I have difficulty urinating and prostate enlargement. Please help.

You can start taking Doudart (Dutasteride and Tamsulosin hydrochloride) one capsule at night before bed daily ...   Read full

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read

Tomato Fever - Causes, Symptoms, Diagnosis, Treatment, and Prevention
Tomato fever is an unidentified and fast-spreading type of viral infection seen in young children. Scroll down to know m...  Read more»
Histrionic Personality Disorder - Causes, Signs, Symptoms, Diagnosis and Treatment
Histrionic personality disorder causes variations in the thinking ability of a person. Read this article to know more.  Read more»
Nighttime Skin Routine for Clear Skin
A skin that gets all the attention during the day requires a chance to repair, rejuvenate and replenish from day damage ...  Read more»

Ask your health query to a doctor online?

Ask an Urologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.