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weak urine flow in the morning only

sometimes on my first urination of the morning i have a difficult time keeping a steady urine flow. the rest of the day i am fine. what causes this? the last year i have had on and off bouts with prostatitis, but i have had this weak morning flow occasionaly for several years, although it does happen more often and more severely lately. i have been to a urologist several times in the last year. he says i have no infection in my urine, did psa screening and did a grahm stain, all were ok. he has had me on cipro a few times which seems to help, but after the perscription is gone, my symptoms  seem to return. why would the cipro help if i have no signs of bacterial infection?
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233190 tn?1278553401
Hello - thanks for asking your question.

One consideration would be any type of prostate disease.  If the prostate was enlarged, it can certainly affect urine flow.  

If prostatitis is the case, then an extended course of antibiotics would be the optimal treatment.  At times, 4-12 weeks of antibiotics may be needed.  

I would make sure that the size of the prostate is within normal limits.  BPH (benign prostatic hypertrophy) or prostate cancer can cause your symptoms.  A digital rectal exam or an ultrasound can also be considered to evaluate the size of the prostate.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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