My urinary problems started years ago with blood in the urine and severe urinary pain. Later I developed dribbling, a very weak stream and a feeling that my bladder was not emptying completely.
Previous reports showed post-void residual urine around 112–116 mL. One old report appears to list a prostate size of about 8 g, and more than one urologist told me there might be an obstruction or abnormality in the urinary passage rather than simple prostate enlargement.
I have previously used Contiflo, levofloxacin and Tamdura at different times. Symptoms improve and then return. I am concerned about needing surgery in the future and would like to know whether the problem can be treated without surgery.
Personal phone number and email address from the original submission have been removed for privacy.
Quick Answer
Your history does not clearly prove that BPH is the main problem. In fact, the reported small prostate measurement and repeated comments about an “obstacle” or abnormal urinary tract make urethral stricture, bladder-neck obstruction, or impaired bladder muscle function important possibilities.
A persistent post-void residual around 112–116 mL is clinically relevant, but it does not by itself tell us whether the cause is prostate obstruction or a weak bladder. Modern evaluation should include uroflowmetry and a repeat post-void residual. If urethral narrowing is suspected, cystoscopy and/or retrograde urethrography can define the location and length of a stricture.
Contiflo 0.4 mg contains tamsulosin. Tamdura contains tamsulosin 0.4 mg plus dutasteride 0.5 mg. These medicines can help true BPH, but they will not open a fixed urethral scar, and dutasteride is most useful when there is demonstrable prostate enlargement.
Do not repeatedly restart Tamdura or antibiotics on your own whenever symptoms return. First establish the diagnosis.
Hello Yogesh,
The most important part of your history is not simply that you have weak flow. It is that your previous doctors apparently questioned whether you had meaningful prostate enlargement at all.
If your old report truly showed a prostate around 8 g, that would be unusually small and would argue strongly against classic BPH as the explanation for persistent obstruction. Because old reports can contain transcription or interpretation errors, I would obtain the original ultrasound or urology report and confirm the actual prostate volume.
Your Symptoms Can Occur With BPH—but Also With Other Obstruction
BPH symptoms can include:
- weak urine stream;
- hesitancy;
- intermittent flow;
- post-void dribbling;
- straining;
- frequency; and
- the sensation of incomplete bladder emptying.
But these symptoms are not specific to BPH.
They may also occur with:
- urethral stricture;
- bladder-neck obstruction or contracture;
- poor bladder muscle contraction (detrusor underactivity);
- neurologic bladder dysfunction;
- urinary stones;
- infection or inflammation; and
- more than one of these problems at the same time.
What Does a Residual Urine of 112–116 mL Mean?
Post-void residual (PVR) is the amount of urine that remains in the bladder after urination.
Your reported values of roughly 112–116 mL are high enough to justify proper follow-up, especially because you also have a weak stream and incomplete-emptying sensation.
However, current European guidance emphasizes that an elevated PVR is not specific for bladder-outlet obstruction. It may result from:
- an obstruction such as BPH or urethral stricture;
- a bladder muscle that does not contract strongly enough; or
- a combination of obstruction and weak detrusor function.
There is no single PVR cutoff that automatically determines treatment.
The Next Test I Would Prioritize: Uroflowmetry
Uroflowmetry measures how quickly and in what pattern urine leaves the bladder.
It can show a low or prolonged flow pattern, but it cannot by itself prove whether the cause is prostate obstruction, urethral narrowing or weak bladder contraction.
That is why uroflowmetry should be interpreted together with PVR, prostate size, examination findings and the rest of your history.
If Urethral Stricture Is Suspected, How Is It Diagnosed?
The 2026 European urethral-stricture guideline recommends uroflowmetry and PVR measurement in suspected stricture disease.
If the suspicion remains, a urologist may use:
- retrograde urethrography (RUG) to show the location and length of a stricture;
- voiding cystourethrography in selected cases;
- cystourethroscopy to look directly inside the urethra and bladder; or
- additional imaging in more complex cases.
Could the Bladder Muscle Be Weak?
Yes.
Long-standing obstruction, aging, diabetes, neurologic disease and other conditions can impair bladder contraction.
If the urologist cannot tell whether poor flow is caused mainly by obstruction or weak bladder function, urodynamic pressure-flow testing may be considered.
This distinction becomes particularly important before surgery. A prostate or urethral procedure can relieve obstruction, but it cannot guarantee normal emptying if the bladder muscle itself is significantly underactive.
What Is Contiflo 0.4 mg?
Current Indian product information identifies Contiflo 0.4 mg as tamsulosin 0.4 mg.
Tamsulosin is an alpha-1 blocker. It relaxes smooth muscle around the prostate and bladder neck and can make urination easier in men with BPH.
It does not shrink the prostate.
Your historical note appears to say Contiflo 0.4 mg was prescribed twice daily. Because dosing details in old records may be incomplete or mistranscribed, I would verify the original prescription rather than repeating that schedule yourself.
What Is Tamdura?
Current Indian product information lists Tamdura as:
- tamsulosin 0.4 mg; plus
- dutasteride 0.5 mg.
Dutasteride is a 5-alpha-reductase inhibitor. Unlike tamsulosin, it can gradually reduce prostate size—but its main value is in men who actually have a demonstrably enlarged prostate and an increased risk of BPH progression.
Why You Should Not Take Tamdura Only When Symptoms Flare
Tamdura is not designed as an occasional “rescue” medicine.
Tamsulosin can work relatively quickly, but dutasteride works gradually over months. Starting and stopping a tamsulosin/dutasteride combination whenever symptoms recur is not an evidence-based way to use the 5-alpha-reductase inhibitor component.
It can also expose you repeatedly to side effects without providing the intended long-term benefit.
Any restart or change should be discussed with the prescribing urologist.
What About the Levofloxacin You Previously Took?
Levofloxacin is an antibiotic. It is not a treatment for BPH or urethral obstruction.
Antibiotics are appropriate when there is evidence of bacterial urinary infection or another susceptible bacterial condition. They should not be repeatedly restarted simply because urinary flow becomes poor.
If you have burning, fever, new urgency or other infection symptoms, urinalysis and urine culture can help determine whether an infection is actually present.
Can You Avoid Surgery?
Possibly—but only after identifying what is causing the obstruction.
| Likely cause | Possible non-surgical approach | When a procedure may still be needed |
|---|---|---|
| True BPH with enlarged prostate | Alpha blocker, 5-alpha-reductase inhibitor when appropriate, tadalafil in selected men, lifestyle measures | Persistent severe symptoms, retention, infection, stones, kidney effects or failed medication |
| Urethral stricture | No medicine reliably removes established scar narrowing | Dilation, internal urethrotomy or urethroplasty depending on location, length and recurrence |
| Bladder-neck obstruction | Alpha blocker may help selected patients | Bladder-neck incision or another targeted procedure when obstruction persists |
| Weak bladder muscle | Timed/double voiding, medication review, treatment of contributing disease; intermittent catheterization in selected patients | Procedure only if significant coexisting obstruction is demonstrated |
If It Really Is BPH, What Non-Surgical Treatments Are Available?
Modern BPH treatment includes more than alpha blockers alone.
Alpha Blockers
Tamsulosin, alfuzosin and related medicines can improve flow relatively quickly by relaxing prostate and bladder-neck smooth muscle.
They do not reduce prostate size and may cause dizziness, low blood pressure or ejaculatory changes.
5-Alpha-Reductase Inhibitors
Finasteride and dutasteride are most useful when the prostate is demonstrably enlarged. They work slowly but can reduce prostate volume and long-term progression risk.
Tadalafil
Daily tadalafil can improve lower urinary tract symptoms and erectile function in appropriately selected men. It should not be used with nitrate medicines and does not treat a urethral stricture.
Combination Therapy
Men with significant symptoms and enlarged prostates may benefit from combinations such as an alpha blocker plus a 5-alpha-reductase inhibitor.
See our BPH medication guide.
What About Your Sexual Problems?
Erectile dysfunction should be assessed separately rather than assumed to be caused entirely by retained urine.
Possible contributors include:
- age-related vascular disease;
- diabetes or metabolic disease;
- low testosterone in selected patients;
- medication effects;
- stress and chronic pelvic/urinary symptoms; and
- other cardiovascular or neurologic factors.
Tamsulosin can cause ejaculatory problems, while dutasteride can contribute to reduced libido, erectile dysfunction and ejaculatory changes in some men.
If sexual function remains impaired, it deserves a specific medical review rather than being treated only by changing urinary medicines.
Do You Need a Strict Water Schedule?
No.
The old advice to drink exactly 100 mL of water 20–25 times per day and assume only a fixed fraction becomes urine has no valid physiological basis.
Your kidneys continuously regulate fluid balance according to intake, salt, hormones, medications, temperature and medical conditions.
A more practical approach is:
- maintain normal hydration;
- avoid unusually large fluid loads at one time if they worsen urgency;
- reduce excessive evening fluids if nocturia is a problem;
- reduce caffeine or alcohol if they worsen symptoms; and
- follow individualized fluid advice if you have heart or kidney disease.
Should You Perform Kegel Exercises by Stopping the Urine Stream?
No—not as a routine training method.
Briefly stopping urine flow can help identify the pelvic-floor muscles, but repeatedly interrupting urination is not the correct way to exercise them.
More importantly, Kegel exercises do not open a urethral stricture, shrink the prostate or correct significant urinary retention.
They are mainly useful for certain types of urinary incontinence.
What I Would Ask Your Urologist Now
- Can we confirm my current prostate volume?
- Was the old “8 g prostate” value correct?
- What exactly did previous doctors mean by an “obstacle” or “sinuous urinary tract”?
- What is my current post-void residual?
- What does my uroflowmetry pattern show?
- Do I need cystoscopy or a retrograde urethrogram to look for a urethral stricture?
- If obstruction versus weak bladder muscle remains uncertain, would urodynamic testing help?
- If my prostate is small, should I be taking dutasteride at all?
- Is my sexual dysfunction medication-related, vascular, hormonal or due to another cause?
- What treatment gives me the best chance of avoiding urinary retention in the future?
When Is Prompt Medical Attention Needed?
- cannot urinate at all;
- develop a painful, increasingly full bladder;
- develop fever or chills with urinary symptoms;
- have visible blood or blood clots in the urine;
- develop severe lower abdominal or flank pain; or
- become acutely unwell.
I would not continue treating this as simple enlarged prostate until the diagnosis is clarified. Your persistent residual urine, long history of weak flow and previous comments about an obstruction in the urinary passage make urethral stricture or another outlet problem important possibilities.
The next useful step is not another course of Tamdura or levofloxacin. It is updated uroflowmetry and post-void residual measurement, confirmation of your prostate volume, and—if urethral narrowing is suspected—cystoscopy and/or retrograde urethrography.
If true BPH is confirmed, there are several non-surgical medication options. If a fixed urethral scar is the problem, however, prostate medicines cannot remove that scar and a targeted procedure may ultimately offer the more durable solution.
Dr. Albana Greca, MD, MMedSc
Family Physician / General Practitioner
Founder & Lead Medical Author, Prostate Treatment Options
Medical References
European Association of Urology. 2026 Guidelines on the Management of Non-neurogenic Male Lower Urinary Tract Symptoms: post-void residual, uroflowmetry and differential diagnosis of bladder outlet obstruction.
European Association of Urology. 2026 Guidelines on Urethral Strictures: diagnostic evaluation with uroflowmetry, PVR, retrograde urethrography and cystourethroscopy.
National Institute of Diabetes and Digestive and Kidney Diseases. Enlarged Prostate (Benign Prostatic Hyperplasia): symptoms, diagnosis and treatment.
Current Indian product information. Contiflo 0.4 mg contains tamsulosin 0.4 mg; Tamdura contains tamsulosin 0.4 mg plus dutasteride 0.5 mg.
Last evidence update: September 2026.