Men’s urinary disorders
Introduction
Urinary problems, or mictional disorders, are a range of symptoms that affect bladder emptying or the quality of the urine stream. They may manifest as a weak or choppy stream, difficulty in urinating, frequent night-time urination, or a feeling of heaviness or blockage.
⚠️ These disorders may be a sign of prostate, bladder or other urinary tract disorders. A complete urological check-up is often necessary to identify the cause and propose appropriate treatment.
Symptoms and clinical forms
Here are the main symptoms of urinary disorders:
1️⃣ Weak or choppy urine stream
- The spray is small, intermittent or "drip".
- Spontaneous pauses may occur during micturition
- Maximum flow is reduced
- The feeling of "having to push" to urinate
2️⃣ Difficulty urinating or emptying the bladder
- Very slow flow, need to wait a long time before the jet starts
- Feeling of incomplete emptying (post-micturition residue)
- Need to "relaunch" the jet
- Sometimes two-stage urination (backflow)
3️⃣ Frequent nocturnal rising (nocturia)
- Getting up several times a night to urinate
- This symptom is particularly annoying and disrupts sleep.
- May reflect bladder overactivity, bladder capacity disorders, partial obstruction or nocturnal polydipsia
4️⃣ Feeling of heaviness or urinary blockage
- Impression of a heavy, full or distended bladder
- Pelvic pain or discomfort
- Sometimes need to "push" or make an abdominal effort to trigger urination
- Feeling of not being able to start the jet
📌 These symptoms may be isolated or associated with one another, depending on the underlying pathology.
Possible causes and mechanisms
Here are the main symptoms of urinary disorders:
1️⃣ Obstruction or resistance to flow
- Benign prostatic hyperplasia (BPH) or prostatic adenoma
- Urethral stricture
- Prostatic hyperplasia
- Male urethral valves
- Stenosis after surgery
- External compression or pathologies of the vesico-prostatic junction
2️⃣ Bladder dysfunction
- Decreased bladder contractility ("lazy" bladder)
- Bladder overactivity / instability of contractions
- Impaired bladder compliance
- Bladder over-/under-capacity
3️⃣ Neurological alterations
- Peripheral neuropathies
- Disorders of the spinal cord or nerve pathways (spinal cord injuries, neurological diseases)
4️⃣ Contributing or associated factors
- Advanced age
- Urinary tract infections
- Medications (anticholinergics, diuretics, etc.)
- Poorly controlled diabetes
- Excessive nocturnal hydration
- Heart failure, sleep disorders
Diagnosis
A rigorous diagnosis is essential to identify the cause(s) of the mictional disorder:
1️⃣ Interrogatory (history-taking)
- Onset and course of symptoms
- Frequency of night-time rising
- Duration of micturition, intermittence, effort required
- Feeling of incomplete emptying
- Associated factors (diuretics, hydration, treatments)
- History of prostatitis, urology or neurology
2️⃣ Clinical examination
- Abdominal examination (palpable bladder)
- Prostate examination (in men)
- Palpation of the perineum, assessment of neurological sensitivity
- Search for a bladder globe
- Palpation and test of perineurethral mobility
3️⃣ Supplementary balance sheet
- Vesico-prostatic ultrasound / post-micturition residue
- Urinary flowmetry: measurement of flow rate and micturition time
- Urodynamics: measurement of bladder pressure, contractility, urethral resistance
- Cystoscopy: in case of suspected urethral lesion or obstruction
- Urinalysis / ECBU : looking for infection
- Voiding diary / intermittent catheterization : quantifying volumes
This assessment helps clarify whether the origin is obstructive, bladder-related, neurological or mixed.
Possible treatments
Treatment options are chosen according to cause, severity of symptoms, patient age and general condition.
1️⃣ Conservative approaches
- Bladder retraining, learning emptying techniques
- Adapting hydration (day/night distribution)
- Correction of aggravating factors (medication, constipation, metabolic disorders)
- Active surveillance if mild symptoms
- Drug treatments according to mechanism: α-blockers (to relax the cervix) 5α-reductase inhibitors (in BPH) Medications to promote bladder contractility
2️⃣ Endoscopic / minimally invasive treatments
- Prostate resection or vaporization (TURP, laser)
- Incision of the bladder neck
- Urethral stricture dilatation
- Targeted endoscopic treatments depending on the lesion
3️⃣ Open surgery or specialized intervention
- Prostatectomy (in certain indications)
- Urethral repair surgery
- Associated bladder interventions according to bladder disorders
📌 Regular follow-up is crucial to measure effectiveness and adjust management.
Why consult Pr Haab?
- Prof. Haab has extensive experience in functional urology, urological proctology and prostate pathology.
- It adopts a personalized, step-by-step 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 dysfunction.
- It provides comprehensive patient follow-up, from diagnosis to post-treatment reassessment.
Do you suffer from urinary disorders?
Requirements
Expertise
Practice path
Each patient benefits from personalized support, from the first consultation to post-treatment follow-up. This includes a precise assessment, a clear presentation of the different treatment options and a progressive approach to treatment, tailored to each patient’s individual situation.
Do you suffer from urinary problems?
Don’t let urinary problems affect your well-being and your intimate life.
Professor François Haab consults in Paris and accompanies you every step of the way, with scientific rigor and human kindness.
📍 Cabinet Urologie Paris Opéra – Paris 17th
📅 Face-to-face consultation or teleconsultation
📞 Book an appointment today
