Problems Passing Urine – Expert Urology Care in London
Difficulty urinating is common in men and may indicate prostate or urinary issues. Early diagnosis makes treatment easier.
Symptoms of Prostate Conditions
Prostate problems can cause different symptoms. Some men have mild signs, while others experience more serious issues.
Diagnosis
We use advanced tests to identify the cause:
- Consultation & Physical Exam: Discuss symptoms and examine the prostate
- Urine & Blood Tests: Detect infection, assess kidney function, PSA and other issues
- Uroflowmetry: Measures the speed and volume of urine flow
- Flexible Cystoscopy: A small camera checks the inside of the bladder and urethra
- Ultrasound or MRI: Visualize the bladder, prostate, and kidneys
- Urethrogram: To assess for length and location of any urethral strictures
- Video Urodynmaics: In specific cases to further understand bladder function and pinpoint obstruction
Causes
Enlarged prostate (BPH): Blocks urine flow as men age
Urinary tract infections (UTIs): Can cause pain and frequent urination
Prostate infection (Prostatitis): Leads to discomfort and urinary problems
Urethral strictures: Narrowing of the urethra slows urine flow
Treatment Options
We diagnose and treat a wide range of conditions affecting how you pass urine using modern tests and personalised care plans. Our focus is early detection, accurate diagnosis, and effective treatment to protect your long-term health.
Medication
Alpha-blockers: Help relax prostate muscles to improve urine flow and reduce difficulty urinating.
Antibiotics: Treat infections such as prostatitis or urinary tract infections (UTIs) effectively.
Other Medications: Reduce inflammation, shrink the prostate, and relieve urinary blockage.
Minimally Invasive Procedures
Endoscopic treatment of strictures (Dilation / Urethrotomy / Optilume Balloon): Gently widens a narrowed urethra to make urination easier.
Endoscopic treatment of enlarged prostate (Urolift/ Rezum): procedures available under local anaesthetic to manage prostate enlargement that blocks urine flow.
Surgery
Urethral Reconstruction: Definitive treatment for complex or recurrent urethral strictures, involves rebuilding the urethra often with grafts
Surgical removal of enlarged prostate tissue: Using a range of techniques including TURP, BNI, HoLEP and Aqua-ablation to remove enlarged prostate tissue to restore normal urine flow.
Treatments for problems passing urine we offer
There are a number of different treatment options for obstruction causing problems passing urine. The table below summarises the options, which we can discuss in more detail to select the right treatment for you.
← scroll left over table to read more
| Treatment | Area Treated | What it does | Advantages at a glance | Disadvantages at a glance |
|---|---|---|---|---|
| Urethral Dilatation/ Optical Urethrotomy | Urethral Stricture | Widens a narrowed urethra with either serial dilatation or a small cut to open up the stricture | Quick and simple day case procedure – catheter usually for only 2-3days. Effective in up to 50% of cases | Less effective in recurrent strictures (<10% success) |
| Optilume device | Urethral Stricture | Uses a drug coated balloon to widen stricture and keep open for longer | Day case procedure with a catheter for 2-3 days. Approximately 70% success at 3 years even with recurrent strictures | Relatively new procedure so long term data unclear. Need to use contraception for 6months after procedure. |
| Urethroplasty | Urethral Stricture | Reconstruction of stricture segment of urethra – often using a graft | Most successful stricture treatment with 85-90% long term (>10year) success | Bigger open operation taking 3-4 hours, with overnight stay and catheter for 2 weeks |
| Urolift | Enlarged prostate | Pins back prostate tissue rather than removing it | Quick daycase procedure. Can be done under local anaesthetic. Often no catheter post op. Better potential for preserving ejaculation post op | Not suitable for larger prostates. May not work. Approximately 1 in 10 men need some further prostate treatment within 3 years |
| Rezum | Enlarged prostate | Uses steam to shrink prostate tissue | Daycase procedure. Can be done under local anaesthetic. Better potential for preserving ejaculation post op. More durable than Urolift. | Not suitable for larger prostates. Needs catheter for longer (3-5 days). Results only evident once prostate shrinks (up to 2-4 weeks). Initial increase in irritative symptoms (frequency/ urgency/ dysuria) |
| TURP/ BNI | Enlarged prostate | Resection of the bladder neck (BNI) or prostate (TURP) to open a wider channel in the prostate | Traditional gold standard treatment. 1-2 day stay with catheter post op | ‘Dry ejaculation’ after procedure. 10-20% need further operation after 5-10 years |
| HoLEP | Enlarged prostate | Complete resection of the prostate using a laser to enucleate the prostate gland | Removes more tissue than a TURP and lasts for longer. Lower risk of bleeding and shorter hospital stay vs TURP. Most suitable for larger prostate glands | ‘Dry ejaculation’ after procedure. Higher chance of temporary dysuria (burning pain) and urinary urgency initially than TURP |
| Aqua-ablation | Enlarged prostate | robot-assisted procedure. uses a heat-free, waterjet to remove prostate tissue | Better preservation of ejaculation than other procedures that resect the prostate. Suitable for all prostate sizes. | Newer procedure – longer term (>10yr) results less clear. Higher risk of initial bleeding post op and irritative symptoms initially (dysuria / frequency/ urgency) |
Frequently Asked Questions
Are all problems passing urine due to an obstruction?
No. While obstruction due to the prostate or in the urethra are the most common causes, some patients will have problems passing urine due to bladder dysfunction. Our comprehensive assessment pinpoints the cause of the problem, and offers the most suitable treatment for you.
My problems were due to a urine infection (UTI). Are antibiotics all I need?
No- while antibiotics will effectively clear your infection. A man should never have even a single UTI. Having one is a sign of a possible underlying problems that needs investigation and treatment to prevent further episodes.
Can medications improve urine flow?
Yes – alpha-blockers and other medications can relieve blockage and improve symptoms. For those with bladder dysfunction, a range of other medications can be used to improve issues with urgency, frequency and nocturia (getting up at night to pass urine).
My problem is due to prostatitis. What can be done?
There are a number of options for prostatitis ranging from longer courses of antibiotics for active infections, to medical treatments to help with symptoms related to inflammation and pelvic floor physiotherapy. Our specialists can expertly guide you through your treatment.
How long is recovery after prostate procedures?
Most men return to normal urination within a few weeks to a couple of months.
Are urinary issues permanent?
Many causes are treatable. Early diagnosis improves outcomes and quality of life.