Dr. Charles Stephen Woolums, MD

It could be various things which cannot be predicted for sure. Seek urologic evaluation.

Grinding the medication will help absorption, but will not change the overall outcome from the medication. Bethancol causes smooth muscle contraction, but in the bladder, it is often in a uncoordinated way. I don’t typically use this medication.

Urinating at night (nocturia) can be caused by many factors. Some people just drink up until bedtime and therefore off load fluid at night. Some people have lower extremity swelling and when you lay down at night fluid circulates more efficiently and the lower extremity fluid recirculates and is off loaded as urine. Some people (older men) have an enlarged and obstructing prostate, and this leads to voiding issues. Treating the prostate often fixes the problem. Point is, there are many causes of nocturia. Speaking to your urologist can help identify your cause of nocturia.

The only stone which can be downsized is uric acid stones - 3% of stones. Most stones cannot be dissolved. Preventing the stones from growing is the key issue. This can be treated with medications.

Many causes of post- prostatectomy ED. Some is just anxiety induced. Time and relaxation help.
Generally it is a nerve injury or nerve stretching from the removal of the gland. The other is a change in blood flow. Improving vasodilation helps the problem
Often time resolves the problem.

Most common cause of recurrent urinary tract infections in an older woman is lack of vaginal estrogen.
Replacing vaginal estrogen resolves many of symptoms.
The other issue though is misdiagnosed .... urgency and frequency is not always a urinary tract infection rather urgency frequency syndrome.