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Radiation for prostate cancer: Difficult urinating after sleeping

Posted by chp @chp, Dec 1, 2023

I am halfway through traditional radiation and am having difficulty urinating in the morning after sleeping. Urination during the daytime while I am active is not a problem, but when I wake in the morning and head to bathroom for the first time, it is difficult even though the urge is strong. I was not having taking tamsulosin prior to radiation and now doctor has me taking maximum dose of tamsulosin which helped initially.

I was not having a problem before diagnosis. Is this a common side effect of radiation?

Any suggestions on what I can do for relief?

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gently | @gently | Dec 2, 2023

Thanks for the question. I'm trying to figure everything out in advance. So you know this is an untried response. Tamsulosin reduces night time production of urine and radiation causes swelling; you may be needing gravity to overcome the the narrowing escape passages for the urine. I would try a different medication, maybe Flomax. I'm going to keep checking your post for better answers.

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1 reply
chp | @chp | Dec 2, 2023
In reply to @gently "Thanks for the question. I'm trying to figure everything out in advance. So you know this..." + (show)
@gently

Thanks for the question. I'm trying to figure everything out in advance. So you know this is an untried response. Tamsulosin reduces night time production of urine and radiation causes swelling; you may be needing gravity to overcome the the narrowing escape passages for the urine. I would try a different medication, maybe Flomax. I'm going to keep checking your post for better answers.

Jump to this post

Thank you for the response. Flomax is the brand name for tamsulosin, so shouldn't need to switch?

Tamsulosin: MedlinePlus
https://medlineplus.gov/druginfo/meds/a698012.html

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seasuite | @seasuite | Dec 3, 2023

I'm in about the same boat, mid way thru radiation. Urinary issues (nocturia, weak stream and urgency) have been about my only life changing symptoms (thankfully). I'm taking Tamsulosin/Flomax, only one capsule and 'keeping my powder dry' if things get worse. Other drugs suggested to me are: Advil/Ibuprofen in significant amounts that I expect will cause upset stomach (then need another drug Pepcid), hence, I haven't taken yet. I read about Solifenacin as another effective drug.

Best of luck and hopes that I.P. Freely will return soon;-)

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drj | @drj | Dec 3, 2023

Post-radiation urination:
I am 18 months post radiation (hydrogel + 5 X), and 6 months post Lupron. Testosterone has finally reappeared, and I could sense it happening before the tests confirmed it. So far, PSA is < 0.1. My night time urination frequency of 1x initially increased to 2x, but returned to 1x in a few months post radiation, so I counted myself lucky. I concluded I had no significant urinary changes post radiation ...... and of course there is a "but". Starting the past three months I seem to be experiencing some occasional weakness in bladder sphincter control during the day when, with no warning, I sense some drops of urine coming down the urethra. At the time, I'm not exerting myself, nor approaching a full bladder, so I have not found a simple explanation. So now, 18 months post radiation and no significant side effects, I have started to wear a small pad in my underwear. My urinary stream may have slowed as well.

I don't know where this is headed. Has anyone experienced anything similar to this observation?
It's another three months before my next PSA, for what that's worth.

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