Posted 1/16/2023 10:32 PM (GMT -5)
It may be that the medication doesn't lose strength. As in my case, it can work well for years, but at a certain point the inward pressure from the BPH, which still continues, probably just overwhelms the relaxation effect the med (still) has, and the urethra becomes increasingly pinched. Flomax worked very well for me--up to the time it began not working so well and we upped the dose, which helped. At a certain point, however, the BPH won, and I had a (successful) TURP. IMO your tamsulosin is having the same physiological effect, but that effect is no longer enough. You can try the two capsules daily as your doc suggested to see if that helps--it very well may--but that is the maximum dosage.
For the record, the TURP reduced my prostate size from about 90 to 30 cc. A few years after my TURP, I had a RP for the (newly diagnosed) cancer. By that time my prostate had grown back up to 60 cc from the BPH. It's not unusual for men with severe BPH to require a second treatment at some point.
My uro explained that one's symptoms from BPH are not always in proportion to prostate size. Sometimes the excess growth is directed outward, with little bother; other men have less growth, but it is directed inward, putting pressure on the urethra and causing pronounced symptoms. I have pictures my uro/surgeon took at the start of my TURP. The urethra was almost totally closed. Looking through it, it appeared like a triangle with the three sides bowed inward, just about meeting in the center. My doc said he was surprised I was still able to pee.
Djin