Why am I not peeing as much as I used to

Symptoms of acute urinary retention may include

Table of Contents Show

Chronic urinary retention
When should I see a health care professional?
What causes urinary retention?
Blockage or narrowing in the urethra or bladder neck
Inefficient bladder contraction (underactive bladder)

the inability to urinate
pain—often severe—in your lower abdomen
the urgent need to urinate
swelling of your lower abdomen

Chronic urinary retention

Chronic urinary retention develops over time and may cause few or no symptoms, which may make it hard to detect. If your chronic urinary retention causes symptoms, they may include

the inability to completely empty your bladder when urinating
frequent urination in small amounts
difficulty starting the flow of urine, called hesitancy
a slow urine stream
the urgent need to urinate, but with little success
feeling the need to urinate after finishing urination
leaking urine without any warning or urge
lower abdominal pain or discomfort

The symptoms of acute urinary retention are often severe and can include abdominal pain and the inability to urinate, whereas chronic urinary retention may cause few or no symptoms.

When should I see a health care professional?

See a health care professional right away if you are unable to urinate or have severe pain in your abdomen. Acute urinary retention can be life threatening.

If you have any of the other symptoms of urinary retention, such as trouble urinating, frequent urination, or leaking urine, talk with your health care professional about your symptoms and possible treatments. Chronic urinary retention can cause serious health problems.

It’s important to see a health care professional if you have symptoms of urinary retention.

What causes urinary retention?

The causes of urinary retention are related to either a blockage that partially or fully prevents urine from leaving your bladder or urethra, or your bladder not being able to maintain a strong enough force to expel all the urine.

Blockage or narrowing in the urethra or bladder neck

For you to be able to urinate normally, all parts of your urinary tract need to work together in the correct order. Urine normally flows from your kidneys, through the ureters to your bladder, and out the urethra. If a blockage or narrowing occurs somewhere along the urinary tract, you may have difficulty urinating, and if the blockage is severe, you may not be able to urinate at all.

Medical problems that may narrow the urethra and block urine flow include

enlarged prostate, or benign prostatic hyperplasia
bladder outlet obstruction, such as urethral stricture or scar tissue in the bladder neck
pelvic organ prolapse, including cystocele and rectocele
urinary tract stones, also called calculi
constipation
pelvic masses, such as noncancerous or cancerous tumors, fibroids, polyps, or clots
tight pelvic floor muscles
infections, such as urinary tract infection, sexually transmitted diseases, or prostatitis
trauma to the pelvis, urethra, or penis

Inefficient bladder contraction (underactive bladder)

You may develop urinary retention when your bladder muscles aren’t able to contract with enough strength or do not contract long enough to empty your bladder completely—also called underactive bladder. Causes of underactive bladder include

Neurological problems. Urinary retention can occur when there is a problem with your nervous system that prevents messages from travelling from your brain to your bladder and urethra. There are many different causes of neurological problems, including

Medicines. Urinary retention can be caused by certain medicines that interfere with nerve signals to your bladder, urethra, or prostate. Examples of these medicines include

Surgery. It is common to develop temporary urinary retention right after surgery. During surgery, you are often given intravenous (IV) fluid, which may lead to a full bladder. You are also given anesthesia, which can prevent you from feeling the need to urinate despite having a full bladder. In addition, pelvic surgery can cause swelling, scar tissue, and trauma that can partially or fully block the flow of urine out of your bladder or urethra.

Weak bladder muscles. Bladder muscles that are weak may not contract with enough strength or force to empty the bladder completely. Causes of weakness can include

age-related loss of bladder muscle strength
overdistention—a bladder that has been stretched such that the muscles are damaged
pregnancy and childbirth
trauma

Medically Reviewed by Nazia Q Bandukwala, DO on May 11, 2021

When you have to pee, you probably don’t give a second thought to getting to the bathroom. But if you have problems with peeing -- pain, leaks, having to go more often, or not being able to go -- you might find it hard to think about anything else.

A number of health conditions can make it hard for you to pee -- or to keep from peeing. Some are minor, and some are more serious. Contact your doctor if you notice any changes with your pee, especially if it affects your day-to-day life.

Get to an emergency room if you have any of the following symptoms:

This article deals with some common reasons for problems with peeing.

If you leak urine and feel like you can’t control your bladder, you may have urinary incontinence (UI). There are several different types of this condition:

Stress incontinence. This happens when the muscles that keep urine in become weak. You may leak when you exercise, walk, bend, sneeze, cough, or lift something heavy.
Overactive bladder. Your brain tells your bladder to empty even when it doesn’t need to. This causes you to feel like you suddenly have to pee and it makes you go more often.
Overflow incontinence. This happens when your body makes more urine than your bladder can hold. It can also happen because your bladder isn’t able to empty properly, so it gets full and causes you to leak.

Urinary incontinence happens in both men and women. Reasons it may occur in men include an enlarged prostate or prostate cancer.

In women, UI may occur because of pregnancy, childbirth, menopause, pelvic organ prolapse, and hysterectomy (surgical removal of the uterus).

For both men and women, UI becomes more common as you age. Over time, your bladder muscle loses its ability to hold urine as well as it used to. Obesity can also lead to UI. Extra weight puts pressure on your bladder. This can make you feel like you have to pee before your bladder is full.

You can develop a UTI when bacteria get into any part of your urinary tract (bladder, urethra, and kidneys). When you have a UTI, it may burn when you pee. You might feel like you have to go more often. Also, the urge to pee may come on suddenly, but only a little urine comes out.

The prostate is a gland that’s part of a man’s reproductive system. It’s located just below the bladder. It surrounds the urethra, which is the tube urine travels through from the bladder to the outside of the body. Certain conditions that affect the prostate can lead to peeing problems. These include:

Enlarged prostate. This is also known as “benign prostatic hyperplasia” (BPH). With this condition, you have to pee often, including during the night. You may leak urine, have a hard time starting to pee, and have a weak stream when you go.
Prostatitis. This is inflammation in or around the prostate. Prostatitis can cause pain during or after peeing. You may also feel the need to go more often and have a hard time holding it.

People with type 2 diabetes may have to pee often. When you have diabetes, sugar builds up in your bloodstream. Your kidneys have to work harder to remove the excess sugar. When they can’t keep up, the sugar goes into your urine and brings fluids from your body along with it. And, the more you pee, the thirstier you feel. As a result, you drink more fluids. That, in turn, makes you have to pee even more.

Certain STIs, such as chlamydia, gonorrhea, and trichomoniasis, can cause pain when you pee.

Kidney stones are small, hard objects made up of minerals that form inside your kidney. When a kidney stone travels through your ureter (the tube that carries urine from your kidney to your bladder) it can cause urinary problems like:

Severe pain in the sides or back
Pain when peeing
Pink, red, or brown colored urine
Cloudy urine
Foul-smelling urine
Frequent need to urinate
Passing small amounts of urine

Certain medications can cause problems peeing. Drugs that might contribute to bladder problems include antidepressants, sedatives, diuretics, high blood pressure medications, heart medications, muscle relaxants, and some antihistamines.

Many different conditions can cause a blockage in your ureter and make it hard to pee. A blockage can also cause blood in your urine. It can form for any of the following reasons:

A stone anywhere in the kidney, ureter, or urethra
Congenital problems (issues you’re born with) that affect how your urinary system is set up
Severe constipation
Endometriosis -- a condition in women that causes the tissue that lines the uterus to grow in other places inside the body
Tumors (cancerour or noncancerous)