Going to the bathroom is something you take for granted — until suddenly, you can’t (or you can’t do it very easily). It’s surprisingly common for men and people assigned male at birth to have trouble peeing, especially as they age into their 50s and beyond.
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Don’t just grit your teeth and ignore the situation, says urologist Brad Gill, MD, MS. There are ways to deal with this inconvenient issue so that you can … well, get back into the flow of life.
So, let’s talk about peeing problems.
An enlarged prostate is, by far, the top reason men have trouble peeing. The prostate gland sits right below the bladder. Urine travels from the bladder through a channel that runs right through the prostate to the urethra, where it exits the body.
As men age, the prostate gets larger — and that has consequences. “That growth squeezes the channel within the prostate, making it more narrow and harder for urine to pass through,” says Dr. Gill. “It’s a slow change, but it’s one you’ll eventually notice when you’re in the bathroom.”
An enlarged prostate can lead to a variety of symptoms, including:
- Weak urine stream.
- Straining to push urine out.
- Trouble getting the flow started or a stream that stops and starts.
- Feeling that you can’t empty your bladder.
- Dribbling after you leave the bathroom.
- Getting up to urinate more during the night.
- An inability to urinate at all.
When it’s hard to pee, you’re less likely to empty your bladder during a restroom visit. That can lead to more frequent (and increasingly frustrating) trips to urinate, and even dribbles in your underwear or embarrassing “accidents” or leakage.
How to deal with trouble urinating
There’s no way to prevent an enlarged prostate. (Again, it’s something that happens naturally.) But if you’re having urinary symptoms, there are plenty of options to help get things back to flowing right.
Hydrate with care
Drink fluids regularly to stay hydrated, but remember this: The more fluid you gulp down, the more often you’ll have to go — especially if it’s a type of fluid that irritates the bladder. So, be smart about what you drink and when you drink it. For instance:
- Cut down on fluid intake in the evening, especially if you find yourself regularly making a 2 a.m. walk to the bathroom to pee. (In general, it’s recommended that people drink less than a glass of water after 6 p.m. or dinnertime.)
- Avoid artificial sweeteners and colorings, which can irritate your bladder.
- Limit coffee, tea and soda consumption, given the caffeine that’s typically in the drinks. Caffeine has a diuretic effect, meaning it makes you have to pee more.
- Watch your alcohol intake. Beer, booze and wine can also act as bladder irritants and a diuretic, which will make you pee more often and produce more urine.
Don’t hold it
Use the bathroom regularly throughout the day. “When you have to go, go,” says Dr. Gill. “Don’t hold it in because the bladder is not as patient as it was when you were younger.”
In general, your bladder should be emptied every two to three hours — a pace rarely encouraged in life. “From a young age, society teaches us to hold our urine,” notes Dr. Gill. “Think about grade school and your teacher telling you it’s not time for a bathroom break yet.”
Practice the ‘double void’
If you feel like you can’t fully empty your bladder, the “double void” may be the right move for you.
“After you finish going to the bathroom, wait 30 seconds to a minute and then try to squeeze out a little bit more,” advises Dr. Gill. “That can help empty the bladder more completely, which can give you more time before your next visit.”
Basically, think of your bladder like a bucket under a leaky pipe: If you only empty it halfway, you need to empty it twice as often to keep it from overflowing.
Review your bedtime routine
Make sure going to the bathroom is the very last thing you do before bedtime. Emptying out before you go to sleep means it will take the bladder longer to fill up (and reach capacity) while you’re in bed.
On a side note, if you are urinating very frequently overnight — say, three or four times (or more) — you may have sleep apnea.
Often associated with snoring, sleep apnea is a condition where breathing can pause. This makes the body produce more urine overnight and causes you to wake frequently. This may lead to the habit of routinely getting out of bed and going to the bathroom.
Skip the supplements
Some herbs and nutritional supplements are marketed for prostate health, but study after study raises doubts about their true effectiveness. In fact, in some instances, supplements may even lead to prostate problems.
Bottom line? Don’t count on finding a “magic pill” for prostate health in the vitamin and supplement aisle. (However, there are medications that may help with this.)
The No. 1 tip for pee problems
While those tips might help you manage stream struggles, they’re no substitute for what really needs to be done: “If you’re having bothersome symptoms, see a urologist,” states Dr. Gill. “Don’t just ignore it.”
Trouble urinating can be more than just a big inconvenience, after all. It can also negatively affect your health or be a sign of a potentially more serious medical issue.
A prolonged blockage can back up in your bladder and then put pressure on your kidneys, which can cause permanent damage over time, says Dr. Gill. Additionally, you may also be more likely to get urinary tract infections and stones in your bladder.
And while an enlarged prostate is typically the cause of urinary flow issues, it’s not always the culprit. Though less common, some types of cancer and various infections can make it hard to go.
Overactive bladder and bladder irritants are also frequent causes of urinary urgency and urinary frequency.
If you see blood in your pee, get on the phone and schedule an appointment with your doctor. “Bloody urine is never normal and is always something that warrants getting checked out right away,” stresses Dr. Gill.
Ditto for if you’re unable to urinate at all.
Treatments for enlarged prostate
Now, the good news. If your growing prostate is making it hard to pee, there are several treatment options that work well to relieve symptoms:
- Medications: “An oral medication is a reasonable place to start,” says Dr. Gill. It’s typically a once-a-day pill, with few side effects. The downside, however, is that if you’re treating prostate enlargement with medication, it means that the medication would be needed for life.
- Minimally invasive treatments: If you aren’t into taking pills or the medication isn’t fully relieving symptoms, urologists also can treat the problem with minimally invasive procedures — often in the office. One uses steam to shrink the inside of your prostate. Another holds the channel open with a series of implants. There are also temporary inserts being studied, which help stretch the channel. These treatments are a nice option, as they often have a low risk of side effects.
- Surgery: Procedures done in the operating room, or surgeries, are the most definitive option. They open the channel through your prostate to relieve symptoms by removing excess tissue that has grown over time. Done under anesthesia, some surgeries can be an outpatient procedure. (Others may require an overnight hospital stay.)
“Problems urinating aren’t normal, but it’s an everyday thing that needs to be talked about,” says Dr. Gill. “Don’t struggle with your symptoms or simply decide to put up with the bother. There’s a list of things that could be going wrong down there.
“So be proactive, talk to your doctors and let us help you figure out how to make things better.”