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Good evening, I am Dr Elliot, I am a GP Urologist so hope I can be of some help
It is reassuring that your PSA is normal, but your symptoms are suggestive of Benign Prostatic Hyperplasia, this would cause altered urination. Regarding passing urine after opening your bowels, if you have larger motions then this can add to the obstruction of the bladder due to the close proximity of the rectum to the prostate and bladder neck.
There are medications that would make a difference to this, equally there are surgical procedures available, used to be considered if medication does not work, but now there are procedures which people have as they do not want to take medication
You need your prostate examined. You will also need a kidney/ureter/bladder ultrasound and a flow study. This will probably require a referral to your local hospital. However medication can be started following an examination to see if there is a difference.
It would also be important to ensure you do not get constipated as this will aggravate your symptoms.
It may also be worth considering an alternative to Sildenafil and try something like Tadalafil. But this is quite expensive and I would suspect your GP would prescribe it if a local urologist advises on its use, or in the short term you could try an increased dose of the sildenafil
No problem at all, I hear these problems in my clinic quite a lot - very common
I would be very grateful if you would kindly rate my response, this is the only way I an credited for answering questions, thank you