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Dr. Andrew Rynne

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Could discontinuation of Tamsulosin cause urinary retention?

Answered by
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Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 9785 Questions

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Posted on Thu, 26 Jul 2018 in Urinary and Bladder Problems
Question: I am a male 75 yrs old. I have never had a problem of urinary retention until Dec 2017. I have three months prior, been taking tacking tamsulosin 2 pills daily (double dose) for three month, stopped 6 weeks ago. Could this drug have caused the urinary retention, if not what could have caused it. I am not on any other drugs at this time. How can I correct the unitary retention. XXXX
doctor
Answered by Dr. P. T. Patil 3 hours later
Brief Answer:
Retention of urine is a warning signal about Enlarged Prostate

Detailed Answer:
Hello
Thanks for query
Based on the facts that you have posted the retention of urine that you get is due to Enlarged Prostate which is common at this age and needs to be investigated to decide about future modality of treatment .

Tomsulosin is a smooth muscle relaxant having specific action in prostatic part of urethra and bladder neck It helps to dilate the urethra and bladder neck and helps to improve urine flow ,It is routinely prescribed to patients with enlarged prostate.

The development of retention of urine strongly suggest that the prostate is grossly enlarged and is a warning signal that it has to be removed by an endoscopic surgery .

Consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.
1) Urine routine and culture.
2) Ultrasound scanning of abdomen and pelvis
3) Serum PSA.
4) Uroflowmentry

Further modality of treatment will be decided by the concerned Urologist depending upon result of these tests and final diagnosis.

In the mean while continue taking antibiotic like Norfloxacin and Nitrofurantoin twice daily along with Tomsulosin once daily .

Hope I have answered your query ,please feel free to ask if you have more questions,I shall be happy to help you
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. P. T. Patil 19 hours later
I sent a follow up question 20 min ago.. Did you get it?

XXXX
doctor
Answered by Dr. P. T. Patil 5 hours later
Brief Answer:
Sorry I did not get your follow up query .

Detailed Answer:
Hello
Thanks for writing again .

I have not received your follow up query ,May be due to some technical issue .

Please report it I will make a precise comment and suggestions after going through it .

Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. P. T. Patil 14 hours later
You suggest removal of the prostate? Will this make me impotent?

My urologist told me that if I could not void that he recommends a TURP Transurethral resection of the prostate. Is this a major operation? What is the past track record for success? What risks does the operation carry. What is the recovery time? How about Greem light laser prostatectomy? Are there any other options?

XXXX

How can I send you the hospital 'diagnostic Results'.

Can it be attached here or do you have an email add?

XXXX
doctor
Answered by Dr. P. T. Patil 9 hours later
Brief Answer:
You will not become impotent after surgery of TURP

Detailed Answer:
Hello
In a given situation it is important that you pass out urine freely and empty your bladder completely than any thing else hence removal of Enlarged Prostate that is blocking urethral passage is absolutely needed .

You can get TURP or Green light Laser Prostatectomy done done.It is Gold Standard
surgery practiced world wide and gives permanent results and improves quality of life .You will need to get hospitalized for 3-4 days .

You will have normal sexual function and climax of sexual pleasure (Orgasm).However as bladder neck is resected during surgery semen will move backward in to bladder and you will not ejaculate outside what is called as Retrograde Ejaculation.

You can upload your records on this forum .There is a link to attach reports and records .

Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. P. T. Patil 15 hours later
Is information I send on this forum private or can others read it?

If after TURP I will have retrograde ejec, how would I get my wife to be pregnant?

I can't find the link to make attachments.

XXXX

Thanks again for you reply
doctor
Answered by Dr. P. T. Patil 4 hours later
Brief Answer:
All the discussions on this forum are secrete and private

Detailed Answer:
Hello
Thanks for follow up
All the discussions are secret and are available to the user only and no third person can have access to it.

If facing problem in making attachments of reports contact support team for help .They will guide you to attach the same .

As regards impregnating your wife after TURP .It is unlikely you can impregnate your wife by natural means as most of the semen goes backwards into bladder .You will need to consult qualified fertility specialist for help to explore possibility of pregnancy with the help of assisted reproductive techniques .

Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. P. T. Patil 45 minutes later
you say that after TURP I will have to get special help to impregnate my wife. Is this also true with Green light Laser Prostatectomy.

What is your opinion of the new REZUM also TUNA?

I am now wearing a jollie catheter. What will happen if I ejaculate while it is connected?
doctor
Answered by Dr. P. T. Patil 2 hours later
Brief Answer:
Retrograde Ejaculation will ccur after Laser Prostatetctomy also.

Detailed Answer:
Hello
Thanks for follow up .
Retrograde Ejaculation is a known complication after surgery of removal of Prostate whether it is TURP or Laser Prostatectomy .

As regards Resum is a new modality of treatment which is not suitable for all patients .It is is still in a stage of innovation and results are not longer lasting and rewarding as TURP or Lase Prostatectomy.

The choice of procedure entirely depends upon the size of the Prostate and severity of obstructive symptoms and your Urologist is the best judge to decide the same which is best for you .

Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. P. T. Patil 4 days later
.Please find the reports attached
doctor
Answered by Dr. P. T. Patil 4 hours later
Brief Answer:
Please read detail answer as below

Detailed Answer:
Hello
Thanks for follow up and uploading Scan report .Based on the report I would recapitulate the findings that you have
1) Enlarged Prostate which has obstructed the outflow
2) Silent Gall Bladder stone
3) Benign cyst in liver
4) Stone in kidney large enough to be treated with appropriate modality .
5) Ventral Hernia

First and foremost you need to resect your Prostate by TURP to make urine passage free of obstruction so that you can pass urine freely .It will help to prevent stone formation and damage the kidney and improve quality of life Ventral Hernia can be operated at the same sitting .

2)Silent Gall bladder stone needs no active intervention at this point of time.

3) Stone in the kidney has to be fragmented either by Extra Corporeal Shock Wave Lithotripst (ESWL) or PCNL depending upon the size of the stone .(Size of the stone is not mentioned in report).

4)Cyst in the liver id benign cyst and can be left alone and observed in future for any increase in size or changes

Hope this helps you
Thanks and Regards.
Dr.Patil..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. P. T. Patil 17 hours later
Sir

What is a Ventral Hernia?

Also, as far as I understood from my Urologist, He was not going to remove my prostate, just scrape it? to allow urine to flow again. (I think that you wrote that when TURP is done the prostate is removed?)

If REZUM System is not as permanent but would allow me to urinate again, and would buy me time, and if it is safer operation, could I do it first? And maybe in that extra time they may improve this procedure, and try it again?

And maybe another better procedure may become available? And maybe I may have a heart attack next week and drop dead and, therefore, not even need an operation?

Thank you very much for your help

XXXX
doctor
Answered by Dr. P. T. Patil 5 hours later
Brief Answer:
TURP is a scientific term used to scrap prostate tissue .

Detailed Answer:
Hello
Thanks for follow up .

TURP is Trans Urethral Resection of Prostate which is commonly used whenever a Prostate that blocks the urinary passage (Adenama) is removed though the prostate is not removed completely .

Ventral Hernia a a protrusion of the fat or intestine through a gap that develops at the mid line where two halves of the body unite together in the anterior abdominal wall.

Rezum therapy is one of the modality that is still under trial and needs research and data regarding long term results .It also needs hospitalization ,anesthesia ,catheterization after surgery like TURP and has not gained popularity as far as outcome of results is concerned.The Only little advantage is it being less invasive compared to TURP. However it is not advisable to undergo multiple surgeries for the same pathology with the ray of hope of invention of new techniques in future when the best results are achieved by doing time tested procedure of TURP.

Choice is your's

Thanks and Regards.
Dr.Patil.

Thanks and Regards.
Dr.Patil



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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