Being unable to pass urine at all is an emergency. A slow stream that has built up over months is a different, treatable problem.
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Difficulty passing urine covers two quite different situations.
Acute retention — suddenly unable to pass any urine, with a full painful bladder — is a medical emergency. It needs a catheter, and it needs it today.
Chronic obstructive symptoms — a weak stream, hesitancy, straining, dribbling and incomplete emptying, developing over months — are usually caused by benign prostate enlargement in men, and are very treatable.
The distinction is straightforward: can you pass urine at all? If not, stop reading and go to A&E.
In women, obstructive symptoms are considerably less common and have a different differential, so they warrant assessment rather than being assumed benign.
Go to A&E. Do not wait, and do not book an appointment with anyone. A full bladder that cannot empty is painful and can injure the kidneys.
Antihistamines, decongestants, amitriptyline and bladder medicines such as solifenacin can all precipitate retention in a man with an enlarged prostate.
Over-the-counter decongestants are a common and avoidable cause of acute retention — worth knowing before you buy a cold remedy.
Tamsulosin relaxes the prostate and works within days. Finasteride or dutasteride shrink it and take three to six months. Daily tadalafil treats both prostate symptoms and erectile dysfunction, which suits some men well.
PSA, kidney function, HbA1c and a urine test.
The International Prostate Symptom Score (IPSS) is a useful questionnaire we can go through, and it gives an objective baseline for whether treatment is helping.
PSA needs discussing before it is done rather than after — it rises with benign enlargement, infection, exercise and ejaculation, so an abnormal result frequently means nothing and can lead to a chain of investigations.
We cannot examine your abdomen for a full bladder, perform a prostate examination, or measure how much urine is left after you go. All three matter here.
A prostate examination cannot be done remotely, and it is part of a proper assessment — so where symptoms are significant or persistent, we will arrange for you to be examined rather than treat blind.
Go to A&E now. This is acute retention, it needs a catheter, and it can damage the kidneys if left.
It is very common with age in men, and it is also treatable. Ageing is an explanation, not a reason to put up with it — and persistent symptoms should still be assessed rather than assumed benign.
For significant or persistent symptoms, yes — and it cannot be done remotely. We would arrange for you to be examined. It is brief, and it gives information no blood test provides.
It is worth a proper conversation first rather than simply ticking a box. PSA rises with benign enlargement, infection, exercise and ejaculation, so results are frequently misleading in both directions. If you take finasteride or dutasteride, your PSA is roughly halved and must be doubled when interpreted.
Yes — decongestants are a recognised cause of acute retention in men with an enlarged prostate, along with antihistamines and amitriptyline. Worth avoiding if you have urinary symptoms.
A loaded rectum physically presses on the bladder outlet. Treating constipation improves urinary symptoms in a meaningful number of men, and it is the easiest thing to fix.
Yes, for many people — waiting a minute or two and trying again empties the bladder more completely and reduces the sense of never finishing.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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