Weak urine stream

A weak urine stream means the force and speed of the flow have reduced, so it may trickle rather than flow, take longer, or stop and start. It is one of the classic 'obstructive' urinary symptoms, and by far the most common cause in men is benign enlargement of the prostate (BPH): the prostate sits around the urethra just below the bladder, and as it enlarges with age it squeezes the passage, weakening the stream and often adding hesitancy (trouble starting), a feeling of incomplete emptying, dribbling at the end, and getting up at night to urinate. Other causes of a narrowed outflow include a stricture (scarring) of the urethra, prostate inflammation or infection (prostatitis), and, less often, a stone or growth. The problem can also come from the bladder side: a bladder muscle weakened by nerve problems, diabetes or long-standing obstruction may not push urine out forcefully. In women, a weak stream is less common and may relate to pelvic-floor or, rarely, obstruction. Because prostate enlargement is so common and usually treatable, and because the symptoms overlap with less common but important conditions, a weak stream that is persistent or bothersome is worth assessing.

• Enlarged prostate (BPH) — by far the commonest cause in men; also hesitancy and night-time urination.
• Urethral stricture — scarring that narrows the urethra.
• Prostatitis — inflammation or infection of the prostate.
• Weakened bladder muscle — from nerve problems, diabetes or long-standing obstruction.
• A stone or, rarely, a growth — blocking the outflow.
• Prostate cancer — an uncommon cause but part of the assessment.

A weak stream, especially in a man, is assessed with a prostate-focused work-up. A urinalysis and sometimes a urine culture check for infection. PSA is often measured to help assess the prostate, interpreted with age and examination. Kidney function (creatinine) is checked if obstruction may be affecting the kidneys, and the flow rate and how well the bladder empties may be measured directly. Mediora.AI can surface a raised PSA or signs of infection from your results that relate to the prostate and outflow; the assessment, including examination of the prostate, belongs with your doctor.