I have a congenital problem, where my bladder has very little muscle texture,,,making complete emptying impossible, in fact, without the help of Bethanechol 25MG and Tamsulosin HCL 0.4MG, I can release so small an amount, that I get infections from urine retension; I have had two procedures to widen the opening at the Bladder/Urethra junction, I believe they are called TURPS...but am resigned to the medication for life....I have no problem with the Bethanechol, for it has no side effects,,,but the Flomax really causes me a lot of fatigue...do you think I could get by with just the Bethanechol,,,or is the Flomax a must also.I take 3 Beths.....1 morning ,1 afternoon and 1 evening and 2 Flomax..1 morning and 1 at night...thank you...Nick


This is really a question for your local urologist, but I would bet that after 2 TURPs you are getting very little benefit from the tamsulosin.  You can always stop it and see what happens.  You should be on Crede (pushing in on the suprapubic area to improve emptying) and/or intermittent catheterization to make sure the bladder gets completely empty at least some of the time.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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