Why does hemorrhoids cause difficulty in urination?

In general, difficulty in urination caused by hemorrhoids may be due to factors such as pain-induced sphincter spasm, abnormal abdominal pressure from straining during bowel movements, concurrent urinary tract infection, thrombosed external hemorrhoids, or incarcerated hemorrhoids. It is recommended to seek medical attention promptly, identify the underlying cause, and receive symptomatic treatment under a doctor's guidance. Specific explanations are as follows:

1. Pain-induced sphincter spasm: Severe pain during a hemorrhoid flare-up can trigger reflexive contraction and spasm of the urethral sphincter, obstructing urine outflow. Soaking in warm water (around 40°C) for 15 minutes can help relieve pain. After soaking, gently massage the lower abdomen and listen to running water to stimulate urination, which helps relax the urethral sphincter.

2. Abnormal abdominal pressure from straining during bowel movements: Excessive straining during defecation worsens hemorrhoid symptoms and causes a sudden increase in intra-abdominal pressure, compressing the urethra and leading to difficulty in urination. Adjust your diet by consuming more fiber-rich foods such as bananas and oats, drink 1500–2000 mL of water daily to soften stools, and avoid excessive straining during bowel movements.

3. Hemorrhoids complicated by urinary tract infection: Hemorrhoids can harbor bacteria that spread to the urethra, causing urinary tract infections. Inflammation from the infection may lead to difficulty urinating. Follow your doctor’s instructions to take medications such as cefuroxime axetil tablets, levofloxacin capsules, or amoxicillin capsules. After urination, clean the perianal area and urethral opening with warm water.

4. Thrombosed external hemorrhoids: Sudden formation of a blood clot in the external hemorrhoidal venous plexus causes severe anal swelling and pain, indirectly affecting urination. Take medications such as ibuprofen sustained-release capsules, micronized purified flavonoid fraction tablets, or diosmin tablets as directed by your doctor. Once the pain subsides, difficulty in urination usually improves accordingly.

5. Incarcerated hemorrhoids: Prolapsed internal or mixed hemorrhoids that cannot be reduced may become incarcerated, causing severe pain and resulting in urinary difficulties. A hemorrhoid reduction procedure—either manual or surgical—is required to reposition the incarcerated tissue, relieve local compression, and restore normal urination.

In daily life, avoid prolonged sitting or standing; get up and move for 5 minutes every hour. Wear loose, breathable cotton underwear and maintain good hygiene by washing and changing frequently to keep the perianal area dry. Develop regular bowel habits, avoid spending too much time on the toilet, and adopt comprehensive care measures to alleviate hemorrhoid symptoms.