A weak stream of urine is observed in diseases of the prostate gland and some other andrological pathologies. It is detected with stones, strictures and tumors of the urethra. In women, it occurs with cystocele and vaginal relaxation. In children, it may be accompanied by infections, urethral valves, enuresis. The cause of the symptom is established according to the survey, laboratory and instrumental studies. Treatment includes antibiotics, antispasmodics, special exercise therapy complexes, physiotherapy, and surgical interventions.
The most common cause of a symptom in the stronger sex is the pathology of the prostate gland. The elderly are predominantly affected.
For malacoplakia, damage to the genital organs is atypical, more often it is detected in the intestines and urinary tract. However, in some cases, granulomatous growths in the prostate area become the cause of the symptom.
Slight hypertrophy of the seminal tubercle is asymptomatic. With progression, the patient complains of a weak or intermittent urine stream, the need for straining, imperative urges, pain during erection, premature ejaculation. With colliculitis, patients are first concerned about discomfort in the perineum, burning and frequent urges. Subsequently, blood appears in the semen, the pressure of urine is weakened.
In acute balanitis, the symptom is due to swelling of the head and narrowing of the external opening of the urethra. Pain, itching, the appearance of plaque and ulceration, erectile dysfunction are determined. In the chronic form, the symptoms are smoothed out. In men with obliterating xerotic balanitis, a weak jet is explained by a decrease in tissue elasticity against the background of sclerotic changes.
Weak flow often accompanies chronic pelvic pain syndrome in men. The disease is provoked by prostate diseases, latent STIs, constipation, muscle weakness, circulatory disorders and other causes. Clinical manifestations resemble prostatitis. In representatives of the older age group, a weak stream is sometimes observed in the absence of lesions of the pelvic organs, associated with changes during the male menopause.
Weak urine stream
In women, a weak urine stream is noted with a large cystocele. The patient complains of a foreign body sensation in the vagina, aggravated by heavy lifting, coughing, defecation and urination. Dysuric disorders increase gradually. Disturbed by the feeling of detrusor overflow, imperative urges, stress incontinence. Acute urinary retention is possible.
Vaginal relaxation syndrome is a polyetiological condition. Weakness of the vagina occurs against the background of difficult childbirth, increased intra-abdominal pressure, lack of estrogen. The main manifestations are "squishy" sounds in the vagina during sex and active movements. Half of the patients have dyspareunia, 20-40% have a weak flow and splashing of urine, stress incontinence.
The sudden weakening and dispersion of the jet, difficulty urinating and sharp pains are characteristic of urethral stones that partially blocked the lumen of the organ. With urethral stricture, the symptom is permanent. Due to the weak jet, patients have to strain the abdominal muscles. Possible leakage of urine, ejaculation disorders, pain syndrome, the appearance of blood impurities in the urine and semen. With secondary infection, pathological discharge is noted.
Sclerosis of the bladder neck often develops after operations for prostate adenoma, in some cases it is congenital. Progressive deterioration of urine outflow is the leading manifestation of the disease. Initially, patients complain of weak flow, difficulty urinating. Then the symptom of incomplete emptying joins.
Benign tumors of the urethra are not necessarily manifested by a lethargic jet - this is just one of the variants of the clinical picture. Perhaps asymptomatic, discomfort, itching, burning, deviation or splashing, partial incontinence. With cancer of the urethra, the symptom is more often found in men, supplemented by urethrorrhagia, purulent discharge, pain, swelling of the external genital organs.
Urethral valves are a congenital anomaly that can cause a weak flow of urine. With a mild course, dysuric disorders, pain during urination, nocturia are observed. Severe forms are manifested by severe difficulties in passing urine, detrusor hypertrophy, sometimes incontinence, and blood in the urine. In young children, a weak stream and urinary retention may indicate the development of cystitis. Sometimes the disorder is found in patients with a polysymptomatic variant of enuresis.
Establishing the nature of the pathology is the responsibility of the urologist-andrologist. Women with diseases of the genital organs are referred for a consultation with a gynecologist. Young patients are examined by a pediatric urologist. Patients are asked to complete a urinary diary. The specialist finds out the time and circumstances of the appearance of a weak jet, the dynamics of the development of the symptom, and other manifestations of the disease.
When conducting a digital examination of the prostate, the doctor determines the size and density of the prostate gland through the rectum, reveals infiltrates, nodes, etc. The method does not allow accurate differentiation of cancer, prostatitis, adenoma and other diseases, the detection of pathological changes is the reason for applying additional verification manipulations.
During a gynecological examination with a cystocele on the anterior wall of the vagina, prolapse of the bladder is detected. A hernia is a soft tumor-like formation that changes volume and density when straining. In patients with vaginal weakness, atony of the walls is found, an increase in the extensibility of the vulvar ring. Additionally, vaginal dynamic tests are performed to assess muscle tone.
To clarify the diagnosis, the following hardware methods are used:
A complex of laboratory examinations for prostate diseases includes analysis of the prostate secretion, bakposev on nutrient media, determination of the PSA level. If an infectious genesis of andrological and urological diseases is suspected, an important part of the diagnosis is the exclusion of STIs. In case of tumors, a histological examination of the biopsy specimen is carried out to clarify the type and degree of neoplasia differentiation.
ureteroscopy
Therapeutic tactics is determined by the nature of the disease that provokes a weak stream:
Depending on the characteristics of the disease, the following surgical interventions are performed:
With valves of the urethra, their endourethral resection is performed; if it is impossible to use resectoscopes in infants, perineal interventions are performed. TUR is recommended for patients with sclerosis and severe ureteral neck obstruction.