Tamsulosin cessation

The measure you're after is what's known as the peak flow rate, measured in ml/sec. This is the best simple indication of any outflow obstruction.

The peak flow rate typically happens 4-8 seconds after the stream starts for a healthy man. A value ≥ 10ml/sec is considered acceptable for a man of our sort of age. For someone with no prostate problems, it could be 25-30ml/sec. The peak flow isn't maintained for long, as flow rate drops off as the bladder empties.

You need a peak flow rate meter to measure this. There are some other things you can measure which might be interesting, but not clinically used. Typical length of time peeing is 22 seconds, and you could measure your average flow rate by timing you peeing into a measuring jug, but I don't know what typical figures for that are.

Men pee slower at night and when they've just woken up. This is because the internal urinary sphincter is under the control of part of the autonomous nervous system which takes longer to wake up than your conscious nervous system, although any outflow obstruction might make this effect more noticeable. However, you don't want to measure your peak flow on these occasions.

One thing to check for is, are you still fully emptying your bladder? Your sphincter relaxes for a set period of time which is normally plenty enough to empty your bladder. However, if you are peeing very slowly, you won't empty your bladder in this time, known as incomplete voiding. This raises the risk of acquiring a urinary infection, because the urine left behind each time keeps any infection seeded. It will also cause you to need the toilet more often because you aren't starting with an empty bladder each time. One way to check for this is to do what's called double voiding. After you finished peeing, wait 60 seconds, and then have another pee. If there's more there than the urine your kidneys collected in that 60 seconds, then you didn't fully empty first time. You can use double voiding as a method to ensure you have fully emptied each time, as an alternative to Tamsulosin.

Yes, I built a peak flow rate meter, using some repurposed kitchen scales and a Raspberry Pi Zero.

Here's a talk I gave on it to a Raspberry Pi group, which unknown to them in advance, turned into a prostate cancer awareness talk. (Unfortunately, the projector kept disconnecting and reconnecting, confusing my laptop.)
https://skillsmatter.com/skillscasts/14627-scales-and-flow-meters

A urologist has since put together an opensource project so you can make your own if you are in to opensource and microcontrollers. He also sells an add-on part to integrate it into hospital systems for professional use.

There are multiple reasons to take Tamsulosin.

After biopsies and brachytherapy, one of those reasons is to try to make it easier to pass out any resulting debris and clots with them less likely to get stuck, particularly while there may also be swelling pressing on the urethra. This is only an issue for a short time after the procedure (allowing longer for LDR/seed brachytherapy as the treatment continues 3-6 months after the procedure).

The main long term reason to take Tamsulosin is to help with relaxing the smooth muscle of the internal urinary sphincter and prostate, to achieve better flow rate. It may be that some time after hormone therapy and/or radiotherapy, a large prostate shrinks, reducing pressure on the prostatic urethra and the need for Tamsulosin reduces.

Just be careful you don't put yourself at risk of retention (not being able to pee) - that requires a visit to A&E, so take advice from your consultant. Some people 'test the water' by trying it alternate days for a while first, although because Tamsulosin is a quick short acting drug, even that might not be safe in all cases. (There's no withdrawal effect, it's just the risk of coming off it, if you did indeed need it to prevent retention.)

It is also an uncontrolled blood pressure reducing drug. When you come off it, keep an eye on your blood pressure as it might rise and need controlling.

Some interesting information there, thank you all. I will try the scales and pee bottle and time it in the interest of accuracy. I suspect that I do not empty my bladder completely, I have had a couple of infections. I could build a proper flow meter, I am "into" electronics.

John

EDIT Using the method of urine amount in a given time I have calculated my average flow to be around 14ml per second. So I conclude I don't have an obstruction.  

Edited by member 16 Nov 2020 at 15:33  | Reason: Not specified

It was a long time ago that I had my flow test. It was done by me peeing into a bucket with a nurse watching and assessing!! Things have moved on since then, fortunately!!

Oh well, another fine mess I got myself into.

John ( 11 pills now and counting!)