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Poor Urine Flow

Men above 60 years of age usually have an enlarged prostate (benign prostatic hyperplasia Benign Prostatic Hyperplasia or obstructing prostate carcinoma Prostate Cancer).
Anatomical or functional obstruction of the urethra or the bladder neck, such as urethral stricture or poor opening, as a consequence of e.g. a trauma or an operation.
Detrusor sphincter dyssynergia in a neurogenic bladder associated with, for example, spinal cord disease or injury.
Poorly contracting detrusor muscle (detrusor myopathy) due to an emptying obstruction and/or overdistension
In women, prolapse of the uterus or urethral mucous membrane

Digital rectal examination (DRE) of the prostate http://www.dynamed.com/condition/benign-prostatic-hyperplasia-bph#RECTAL
Palpation and percussion of the bladder to detect retention Urinary Retention
Measurement of residual urine volume: ultrasonography Determining the Volume of Residual Urine by Ultrasonography (or single catheterization) after voiding
Interpreting the residual urine volume:
- < 100 ml normal
- > 200 ml requires further investigations
- > 400 ml requires bladder catheterization (cystostomy, long-term catheterization or intermittent self-catheterization).
Difficulties with catheterization may suggest urethral stricture.
Plasma prostate-specific antigen (PSA) in men
Symptom questionnaire (IPSS International Prostate Symptom Score (IPSS) http://www.dynamed.com/condition/benign-prostatic-hyperplasia-bph#PROSTATE_SYMPTOM_QUESTIONNAIRES or DAN-PSS)
Indications for hospital referral: see prostatic hyperplasia Benign Prostatic Hyperplasia
In hospital, urine flow measurement http://www.dynamed.com/condition/benign-prostatic-hyperplasia-bph#NONINVASIVE_URODYNAMIC_TESTING is the primary investigation.