Urinary disorders in men

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Urinating without discomfort: identify the cause and take action

Understanding urinary problems: weak stream, or nighttime urination. Professor François Haab offers a comprehensive assessment and tailored treatments.

Introduction

Introduction

Urinary disorders, or voiding dysfunction, encompass a variety of symptoms that affect bladder emptying or the quality of the urine stream . These can manifest as a weak or intermittent stream, difficulty urinating, frequent nighttime awakenings, or a feeling of heaviness or blockage. These disorders can be a sign of prostate or bladder problems, or other alterations of the urinary tract. A complete urological evaluation is often necessary to identify the cause and determine the appropriate treatment.

Symptoms and clinical forms

  • The jet is small in caliber, intermittent, or "drip-like".
  • There may be spontaneous pauses during urination.
  • The maximum flow rate is reduced
  • The sensation of "having to push" to urinate
  • Very slow flow rate; you have to wait a long time before the stream starts.
  • Sensation of incomplete emptying (post-void residual)
  • Need to "restart" the jet
  • Sometimes urination occurs in two stages (backflow).
  • Getting up several times during the night to urinate
  • This symptom is particularly bothersome and disrupts sleep
  • May reflect overactive bladder, bladder capacity disorders, partial obstruction, or nocturnal polydipsia
  • The sensation of a heavy, full, or distended bladder
  • Pelvic pain or discomfort
  • Sometimes you need to "push" or make an abdominal effort to trigger urination.
  • Feeling like I couldn't start the jet

Expertise in male urinary disorders

Possible causes and mechanisms

  • Benign prostatic hyperplasia (BPH) or prostatic adenoma
  • Urethral stricture
  • Prostatic hyperplasia
  • Urethral valves in men
  • Narrowing after surgical procedures
  • External compression or pathologies of the vesico-prostatic junction
  • Decreased bladder contractility (a "lazy" bladder)
  • Overactive bladder / unstable contractions
  • Altered bladder compliance
  • Bladder over/undercapacity
  • Peripheral neuropathies
  • Disorders of the spinal cord or nerve pathways (spinal cord injuries, neurological diseases)
  • Advanced age
  • Urinary tract infections
  • Medications (anticholinergics, diuretics, etc.)
  • Poorly controlled diabetes
  • Excessive nighttime hydration
  • Heart failure, sleep disorders

Diagnosis

  • Onset and progression of symptoms
  • Frequency of nighttime awakenings
  • Duration of urination, intermittentness, effort required
  • Sensation of incomplete drainage
  • Associated factors (diuretics, hydration, treatments)
  • History of prostate, urological or neurological problems
  • Abdominal examination (palpable bladder)
  • Prostate examination (in men)
  • Palpation of the perineum, assessment of neurological sensitivity
  • Search for a bladder globe
  • Palpation and testing of perineo-urethral mobility
  • Bladder and prostate ultrasound / post-void residual
  • Urinary flowmetry: measurement of flow rate and urination time
  • Urodynamics: measurement of bladder pressures, contractility, and urethral resistance
  • Cystoscopy: in case of suspicion of urethral lesion or obstruction
  • Urine analysis / Urine culture: testing for infection
  • Voiding diary / intermittent catheterization: quantification of volumes

Expertise

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Possible treatments

  • Bladder rehabilitation, learning bladder emptying techniques
  • Hydration adjustment (daytime/nighttime distribution)
  • Correction of aggravating factors (medications, constipation, metabolic disorders)
  • Active monitoring if symptoms are mild
  • Drug treatments according to the mechanism: α-blockers (to relax the bladder neck), 5α-reductase inhibitors (in BPH), and drugs that promote bladder contractility.
  • Prostate resection or vaporization (TURP, laser)
  • Bladder neck incision
  • Dilation of urethral stricture
  • Targeted endoscopic treatments depending on the lesion
  • Prostatectomy (in certain cases)
  • Urethral repair surgery
  • Associated bladder interventions depending on bladder disorders

Why consult Professor Haab?

  • Professor Haab has extensive experience in functional urology, urological proctology and prostate pathologies.
  • He adopts a personalized and progressive approach, prioritizing the least invasive solutions first. Post-treatment reassessment.
  • He is trained in modern techniques of endoscopy, minimally invasive prostate surgery and management of bladder dysfunctions.
  • It provides comprehensive patient follow-up, from diagnosis to post-treatment reassessment.

Experience

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Each patient benefits from personalized support, from the initial consultation to post-treatment follow-up. The process includes a thorough assessment, a clear presentation of the various treatment options, and a gradual approach tailored to each individual’s situation.

Are you suffering from urinary problems?

Don’t let urinary problems impact your well-being and intimate life. Professor François Haab practices in Paris and supports you at every stage of your journey, with scientific rigor and compassionate care. Urology Clinic Paris Opéra – Paris 17th Arrondissement. In-person or teleconsultation available. Book your appointment today.

FAQ – Frequently Asked Questions

What are the signs of urinary problems in men?

Typical symptoms include a weak urine stream, difficulty starting urination, repeated nighttime awakenings (nocturia), urgency, and a feeling of incomplete bladder emptying.

Is prostate adenoma still the cause?

This is the most common cause after age 50, but not the only one: overactive bladder, urethral stricture, or neurological disorders can produce similar symptoms. Furthermore, prostate size isn’t the only factor: a small prostate can be very obstructive.

What assessment has been carried out?

The assessment includes an interview with a voiding diary, uroflowmetry (measurement of urinary stream force), ultrasound with post-void residual measurement, and PSA testing as part of screening. A complete urodynamic evaluation is sometimes necessary.

Is surgery always necessary?

No. Many patients find relief through lifestyle changes and medication. Surgery is only considered if medical treatment fails or if complications arise, and today there are techniques that preserve ejaculation in the majority of cases.

Pr François Haab's expertise

Chirurgien Urologue à Paris

Pr François Haab

Urinary disorders in men: there are solutions.

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