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Frequent urination and prescribed flomax. No signs of infection and had urinalysis. Had hip replacement. Suggestions?

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General & Family Physician
Practicing since : 2007
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I am a 58-year old male and have had more frequent need to urinate with some urgency and sometimes multiple need to get up at night to urinate.
Prostate is "normal for my age" according to recent digital exam, my doctor prescribed Flomax which didn't seem to help much and I stopped taking it with his approval. I recently had an accident which never happened before -- was driving for a few hours, felt no real need to urinate for an unusually long period of time for me lately(a few hours)and then got out of the car for gas and had to go immediately and while waiting to get in washroom, wet myself. I am involved with important meetings related to my career and am very worried about this. No classic signs of infection, (burning, blood, cloudy urine); had urinalysis with annual exam at end of XXXXXXX and was normal. I take 10 mg Lexapro, a multiple vitamin and 600 +D Caltrate daily. (I fractured my hip after a bad fall on ice and had hip replacement in February of this year). My doctor is suggesting trying another prostate type med and if it doesn't help see a urologist. I drink coffee at breakfast only, and typically one or two cans of diet Cokes a day. Any suggestions other than what my doctor mentioned?
Posted Wed, 4 Sep 2013 in General Health
Answered by Dr. Lohit K 1 hour later
Brief Answer:
Prostatomegaly, UTI. Needs investigation

Detailed Answer:
Hi thanks for using XXXXXXX

Being a GP if someone comes to my clinic with such complaints I would first rule out the following in the order of priority with physical examination and blood testing.

1. Prostatomegaly: The digital examination may some times go wrong, so I advice you to check with USG abdomen and pelvis including post void scan for urine volume with in the bladder for right diagnosis.

For the management of prostatomegaly along with Flomax, 5-alpha-reductase inhibitors such as dutasteride can provide relief within 48 hours. So your doctor might be telling the same for your management.

2. UTI: Even though you had it done urine examination in XXXXXXX the chance of being infected after that is there. Because of frequent urination kindly test for urine routine once again along with complete haemogram.

3. Stress incontinence:In this there is unavoidable urination in stressful condition like cough, sneezing. This may occur due to loss of sphincter tone. The cause may be due to fractured hip or due to surgery (Nerve injury). If present you require bladder training and pelvic muscle exercises.

With these maintain your sugar level and body weight under normal range and do regular exercises. This may help you.

Hope I answered your query. Feel free to ask me if any further queries.

Wish you good health and success in your career.

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