Treatment for Men with Irregular or Intermittent Urine Flow and Inconsistent Urination in New York City
by Dr. Alex Shteynshlyuger, a board-certified urologist and specialist in the treatment of enlarged prostate, BPH and urinary retention. He is one of the first urologists in the US and NYC to offer Urolift and prostate enucleation, an alternative to traditional TURP as a treatment for enlarged prostate.
What are the Causes of Irregular and Intermittent Urination in Men?
Inconsistent urine flow is one of the most common male bladder problems caused by an enlarged prostate. Often men experience pressure in the lower abdomen, feel the need to strain to push the urine out when the prostate grows to obstruct urine flow. As a result of an enlarged prostate, men often experience intermittent urine flow which can be accompanied by slow and painful urination. Occasionally dribbling after urination occurs.
The most common cause of irregular urine flow due to the enlarged prostate is benign prostatic hyperplasia (BPH). BPH occurs as men get older and the prostate grows in size. BPH typically occurs in men in late 40s around age 50 but can occur earlier or later in some men. Usually, the symptoms occur slowly and men do not notice them and often do not see a doctor to address them.
Another cause of enlarged prostate is prostate cancer which can present with similar symptoms to BPH. As a result, it is important for a urologist to evaluate each patient to determine whether the patient is at risk of having prostate cancer whether the symptoms are simply caused by BPH enlarged prostate. Blood tests such as the PSA test, 4KScore used to distinguish between BPH and prostate cancer. Sometimes prostate biopsy, prostate MRI or additional testing may be required.
UTI or urinary tract infection can also cause slow and painful urination, frequent urination and dribbling, pressure-like sensation in the lower abdomen and split urine stream. UTI can be caused by enlarged prostate and incomplete bladder emptying but may also result from other causes such as bladder stones. UTI in men is treated with antibiotics. If UTI keeps occurring the underlying cause such as enlarged prostate, bladder stones or kidney stones need to be addressed and treated.
STI sexually transmitted diseases (STD) can also lead to intermittent urination and inconsistent urine stream in men. Often peeing is not continuous and men may notice a split urine stream. Symptoms typically occur a few days to a week after sexual intercourse. Usually, urinary problems in men caused by STDs are easily treated with antibiotics.
Tests and Studies Often Used in Diagnosis of Men with Inconsistent Urine Flow
For men with urinary problems that include intermittent urine flow with stop and start urination, blood tests including PSA, STD tests, and creatinine levels are often performed. Urine tests including urinalysis, urine culture and possibly STD testing for gonorrhea, chlamydia and Ureaplasma infection performed. Additional diagnostic tests may include cystoscopy, urodynamic testing, uroflow test and post-void residual test.
Treatment Options for Men with Intermittent and Irregular Urine Stream
Treatment of men with urinary problems that result in intermittent pee flow is aim to treat the underlying problem that caused inconsistent urine stream.
When the urinary problem in men is caused by swollen prostate as a result of urinary tract infection or sexually transmitted disease (STD), antibiotics were used to treat the underlying infection.
When the problem is caused by scar formation in the urethra leading to urethral stricture, urethral dilatation, urethral stricture incision or urethroplasty may be necessary to solve the problem of poor urine flow.
When urinary problems are caused by prostate growth due to BPH, treatment of enlarged prostate with medication such as alfuzosin, Rapaflo, and finasteride is often effective. Office procedures such as Urolift procedure, REZUM procedure for BPH can be performed to widen the prostatic urethra so that urine can flow more easily. Other procedures chest such as prostatic artery embolization (PAE), Butterfly, iTind for BPH, and Aquablation of the prostate are currently being investigated in the treatment of blockage caused by an enlarged prostate.
When urinary problems are caused by prostate cancer, treatment of prostate cancer is usually necessary. In addition, medications and treatment options used for BPH are usually helpful.
For patients with more severe symptoms such as frequent urination and incomplete bladder emptying resulting in intermittent 10 to regular urine flow, enlarged laser treatment with prostate laser surgery such as HoLAP procedure, and “Roto-Rooter prostate surgery” or bipolar TURP procedure is very effective. When bladder stones are present in the bladder, these can often be broken during the same procedure.
Intermittent Urine Flow at Night and During the Day
One of the first symptoms of an enlarged prostate that causes intermittent urine flow is urination at night. Often, irregular urine flow occurs early in the morning initially and subsequently starts to occur during the day as well. This is a result of the poor functioning of bladder muscles when they are over-distended due to the filling of a bladder with urine at night.
What are the Risks of Irregular Urination and Intermittent Urine Flow?
Men with irregular urination and intermittent urine flow often experience a split urine stream which makes the urine stream go sideways and makes it difficult to aim the stream in the toilet. This can cause urine stream to miss the toilet, which can be embarrassing when visiting other people homes and causes discord at home.
Intermittent urination is usually a sign of significant underlying bladder problem, most often incomplete bladder emptying can predispose to urinary tract infections, bladder stone formation, and renal insufficiency (damage to the kidneys). An enlarged prostate can also lead to blood in urine.
Intermittent urination can also cause pain and discomfort in the lower abdomen, urethra, and pain in the penis especially at the tip of the penis due to incomplete bladder emptying. Nocturia (nighttime urination) can cause multiple problems including falls in the elderly, poor energy levels and sleepiness during the day as well as unhappy mood due to poor sleep.
Why Choose New York Urology Specialists for Treatment of Urinary Retention Caused by Enlarged Prostate?
- All treatment is performed by a Board-certified urologist experienced in treating men with symptoms of BPH using medical therapy, minimally invasive therapies, lasers and open surgery.
- We are one of the few practices in the region to offer a full range of options for treatment of BPH.
- We offer BPH treatment options under local anesthesia which avoids the risks, costs, and recovery from general anesthesia. Most men are able to return to office work and other normal activities the next day.
- Extensive Experience: Hundreds of men treated successfully using medical therapy, Urolift, lasers for BPH (Holmium, Thulium, Evolve, Greenlight lasers), Bipolar TURP, traditional TURP, open suprapubic prostatectomy, robotic suprapubic prostatectomy for BPH.
- We treat men with BPH who have heart problems (hypertension, CAD, CHF), renal failure (ESRD) on hemodialysis, men on blood thinners such as aspirin, Lovenox, Coumadin (Warfarin), apixaban, rivaroxaban (Xarelto).
When it comes to experience and innovation – New York Urology Specialists are a step ahead. Better Science Means Better Care. We specialize in minimally invasive highly effective treatment for symptoms of enlarged prostate and BPH. Many treatment procedures are performed in the convenience and privacy of office settings under local anesthesia.
Medicare and major insurances accepted. We offer affordable rates and financing options.
Schedule an Appointment with Dr. Shteynshlyuger:
Dr. Alex Shteynshlyuger is a fellowship trained board-certified urologist with expertise in evaluation and treatment of urinary problems in men. He uses modern effective and proven treatment methods including prostate enucleation and Urolift for BPH. He is highly recommended by top primary care physicians in the New York area.
He has successfully performed hundreds of prostate procedures in adults. Urolift procedures are performed in the office under local anesthesia, in a surgical center and affiliated hospitals under anesthesia.
We offer affordable, highest-quality urology care with or without insurance. Find out our office hours or directions to our office. We offer weekday, weekend and evening office hours.