Clinical case review

An older man with problems urinating

Phillip D Stricker AO



Interrupted urinary flow is usually associated with other symptoms of bladder outlet obstruction rather than being an isolated symptom.

Article Extract

Case scenario

Cliff is a 63-year-old man with type 2 diabetes who is being treated for high blood pressure and high lipid levels. He presents to his GP concerned about an ongoing problem that is now occurring every time he urinates. He reports that he starts to urinate with a normal strong stream but the flow suddenly completely stops (like ‘turning off the tap’) and then, after an interval of about 30 seconds, begins again and continues freely until completion. There is no pain, haematuria, hesitancy, dribbling or nocturia. His prostate is not clinically enlarged and his prostate specific antigen (PSA) level is 0.3 ng/mL.

What is happening to Cliff?