OBJECTIVE: To investigate the risk factors for depression in middle-aged and elderly Chinese male patients with benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS). METHODS: Based on the data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), we included 8 426 male participants aged ≥ 45 years in this study, and explored the risk factors for depression in patients with BPH/LUTS by logistic regression analysis. RESULTS: Among the total number of participants, there were 1 447 cases of BPH/LUTS, with a prevalence rate of 17.2%, and 36.5% of the patients (529/1 447) were complicated by depression. Logistic regression analysis showed that underlying diseases were the risk factors for depression in patients with BPH/LUTS (OR = 1.29, 95% CI: 1.03－1.62), while the protective factors against the condition included high school education or above (OR = 0.52, 95% CI: 0.36－0.75), urban residence (OR = 0.75, 95% CI: 0.60－0.95), eastern region (OR = 0.61, 95% CI: 0.38－0.97), and 6－9 h/d sleep (OR = 0.52, 95% CI: 0.41－0.66). CONCLUSION Underlying diseases, education level, residential area, geographical region, and sleep duration are influencing factors for depression in middle-aged and elderly male patients with BPH/LUTS in China and deserve the attention of clinicians.
Humans ; Male ; Prostatic Hyperplasia/psychology* ; Risk Factors ; Depression/etiology* ; Aged ; Middle Aged ; Lower Urinary Tract Symptoms/psychology* ; China/epidemiology* ; Logistic Models ; Prevalence ; Longitudinal Studies

This study investigated the relationship of personality, depression, somatization, anxiety with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). The LUTS/BPH patients were evaluated with the International Prostate Symptom Score (IPSS), 44-item Big Five Inventory (BFI), the Patient Health Questionnaire-9 (PHQ-9), the PHQ-15, and 7-item Generalized Anxiety Disorder Scale (GAD-7). The LUTS/BPH symptoms were more severe in patients with depression (p=0.046) and somatization (p=0.024), respectively. Neurotic patients were associated with greater levels of depression, anxiety and somatisation (p=0.0059, p=0.004 and p=0.0095, respectively). Patients with high extraversion showed significantly low depression (p=0.00481) and anxiety (p=0.035) than those with low extraversion. Our exploratory results suggest patients with LUTS/BPH may need careful evaluation of psychiatric problem including depression, anxiety and somatization. Additional studies with adequate power and improved designs are necessary to support the present exploratory findings.
Anxiety Disorders ; Anxiety* ; Depression* ; Extraversion (Psychology) ; Humans ; Lower Urinary Tract Symptoms* ; Prostate ; Prostatic Hyperplasia*

This is the first study to investigate the influence of depression, anxiety and somatization on the treatment response for lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). The LUTS/BPH patients were evaluated with the Korean versions of the International Prostate Symptom Score (IPSS), the Patient Health Questionnaire-9 (PHQ-9), the 7-item Generalized Anxiety Disorder Scale (GAD-7) and the PHQ-15. The primary endpoint was a responder rate defined by the total score of IPSS (< or = 7) at the end of treatment. The LUTS/BPH severity was significantly higher in patients with depression (whole symptoms P = 0.024; storage sub-symptom P = 0.021) or somatization (P = 0.024) than in those without, while the quality of life (QOL) was significantly higher in patients with anxiety (P = 0.038) than in those without. Anxious patients showed significantly higher proportion of non-response (odds ratio [OR], 3.294, P = 0.022) than those without, while somatic patients had a trend toward having more non-responders (OR, 2.552, P = 0.067). Our exploratory results suggest that depression, anxiety and somatization may have some influences on the clinical manifestation of LUTS/BPH. Further, anxious patients had a lower response to treatment in patients with LUTS/BPH. Despite of limitations, the present study demonstrates that clinicians may need careful evaluation of psychiatric symptoms for proper management of patients with LUTS/BPH.
Anxiety/epidemiology/*psychology ; Causality ; Comorbidity ; Depression/epidemiology/*psychology ; Humans ; Lower Urinary Tract Symptoms/epidemiology/prevention & control/*psychology ; Male ; Middle Aged ; Outcome Assessment (Health Care)/methods ; Prostatic Hyperplasia/epidemiology/*psychology/*therapy ; Psychometrics/methods ; Republic of Korea/epidemiology ; Risk Factors ; Severity of Illness Index ; Somatoform Disorders/epidemiology/*psychology ; Treatment Outcome

This is the first study to investigate the influence of depression, anxiety and somatization on the treatment response for lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). The LUTS/BPH patients were evaluated with the Korean versions of the International Prostate Symptom Score (IPSS), the Patient Health Questionnaire-9 (PHQ-9), the 7-item Generalized Anxiety Disorder Scale (GAD-7) and the PHQ-15. The primary endpoint was a responder rate defined by the total score of IPSS (< or = 7) at the end of treatment. The LUTS/BPH severity was significantly higher in patients with depression (whole symptoms P = 0.024; storage sub-symptom P = 0.021) or somatization (P = 0.024) than in those without, while the quality of life (QOL) was significantly higher in patients with anxiety (P = 0.038) than in those without. Anxious patients showed significantly higher proportion of non-response (odds ratio [OR], 3.294, P = 0.022) than those without, while somatic patients had a trend toward having more non-responders (OR, 2.552, P = 0.067). Our exploratory results suggest that depression, anxiety and somatization may have some influences on the clinical manifestation of LUTS/BPH. Further, anxious patients had a lower response to treatment in patients with LUTS/BPH. Despite of limitations, the present study demonstrates that clinicians may need careful evaluation of psychiatric symptoms for proper management of patients with LUTS/BPH.
Anxiety/epidemiology/*psychology ; Causality ; Comorbidity ; Depression/epidemiology/*psychology ; Humans ; Lower Urinary Tract Symptoms/epidemiology/prevention & control/*psychology ; Male ; Middle Aged ; Outcome Assessment (Health Care)/methods ; Prostatic Hyperplasia/epidemiology/*psychology/*therapy ; Psychometrics/methods ; Republic of Korea/epidemiology ; Risk Factors ; Severity of Illness Index ; Somatoform Disorders/epidemiology/*psychology ; Treatment Outcome

PURPOSE: To find the association of trial without catheter (TWOC) outcome for first spontaneous acute urinary retention (AUR) in benign prostatic obstruction with age, prior lower urinary tract symptoms (LUTS), retention volume at catheterization (RV), and size of prostate. METHODS: Our prospective observational analytical (interventional) study enrolled 77 cases of spontaneous AUR over 24 months. After clinical evaluation, digital rectal examination, and transabdominal ultrasonography, all patients were catheterized per urethra and their RV was recorded. TWOC was administered after 2 or 3 doses of 0.4 mg tamsulosin-oral absorption control system and after 48-72 hours had passed. A successful endpoint was defined as a maximum flow-rate, >5 mL/sec; voided volume, >100 mL; postvoid residue, <200 mL; and voiding within 6 hours of catheter removal. Data obtained from 58 patients were analyzed after excluding the cases lost to follow-up and secondary exclusion. Age, RV, duration of LUTS, and prostate volume on examination and ultrasonography (PUSG) were recorded and statistically analyzed. Prostate-specific antigen levels were obtained on follow-up and cases of cancer, as seen on transrectal ultrasound-guided biopsy, were secondarily excluded. RESULTS: The patients had a mean age of 65.89+/-8.67 years. Prior LUTS was seen in 35 patients (2.07+/-2.91 months). The mean PUSG and RV were 46.81+/-20.58 mL and 854.8+/-36.26 mL, respectively. Thirty patients underwent a successful TWOC; a mean age of 63.13+/-8.58 years (mean+/-standard deviation; unpaired t-test; P=0.0053) and a PUSG of < or =45 mL (Pearson chi-square test; P=0.0427) were significantly associated with a successful outcome. CONCLUSIONS: There is a significant association between TWOC outcome, age (P=0.0053), and PUSG (P=0.0427).
Absorption ; Biopsy ; Catheterization ; Catheters ; Digital Rectal Examination ; Follow-Up Studies ; Humans ; Lost to Follow-Up ; Lower Urinary Tract Symptoms ; Prospective Studies ; Prostate ; Prostate-Specific Antigen ; Retention (Psychology) ; Sulfonamides ; Urethra ; Urinary Retention ; Urination Disorders

PURPOSE: Pelvic floor muscles play an important role in female sexual function. Urinary incontinence is one of the complex symptoms of pelvic floor relaxation. The purpose of the present study was to evaluate the effects of behavioral treatment on the sexual life variables and quality of life in stress urinary incontinent women. MATERIALS AND METHODS: Fifty women with clinically and urodynamically proven stress urinary incontinence were randomly selected, and treated with functional electrical stimulation (FES) -Biofeedback. The FES-Biofeedback treatment was performed for 20 min per session, 2 sessions a week, for 6 weeks. The treatment consisted of electrical stimulation (35Hz and 50Hz, simultaneously) for 24 seconds, and the biofeedback, composed of 3 phases of contraction, lasted for 32 seconds. The outcome measures on the sexual life variables and quality of life scales were assessed by the Bristol Female Lower Urinary Tract Symptoms questionnaire and a self-developed questionnaire, based on the Brief index of sexual Functioning for women (BISF-W). RESULTS: The general quality of life scores were significantly improved after 6 weeks of FES-Biofeedback (p<0.05). The quality of orgasms, sexual interest, sexual activity and sexual anxiety were significantly improved after the FES-Biofeedback (p<0.05). Changes in the scores for the degree of satisfaction in those variables also showed statistical significance (p<0.05). CONCLUSIONS: Women with incontinence were dissatisfied with their sexual life due to various symptoms associated with their urinary symptoms or symptoms that result from pelvic floor relaxation. The FES-Biofeedback therapy showed positive effects on improving, not only stress incontinence, but also sexual life variables and the life quality.
Anxiety ; Biofeedback, Psychology* ; Electric Stimulation ; Female* ; Humans ; Lower Urinary Tract Symptoms ; Muscles ; Orgasm ; Outcome Assessment (Health Care) ; Pelvic Floor ; Quality of Life* ; Surveys and Questionnaires ; Relaxation ; Sexual Behavior* ; Sexuality ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Weights and Measures

PURPOSE: The aim of this study was to evaluate the effectiveness of external sphincter relaxant and biofeedback with electrical stimulation therapy (EST) in patients who did not respond well to antibiotics. MATERIALS AND METHODS: One hundred-five patients with a diagnosis of female urethral syndrome were entered in this study. Antibiotics were given as first-line therapy for about 3 months. In cases of recurrent or persistent urethral syndrome, antibiotic therapy combined with external sphincter relaxant or biofeedback with EST were performed. According to video-urodynamic analysis, 31 patients (29.5%) were external sphincter relaxant group who showed functional urethral obstruction and 41 patients (39.5%) were biofeedback with EST group who had severe pain or discomfort with irritative voiding symptoms. Subjective symptom was measured before and after therapy using the Bristol Female Lower Urinary Tract Symptoms questionnaire. RESULTS: Thirty-three patients (31.4%) of all patients (n=105) were terminated with antibiotic therapy alone and 7 (21.2%) patients were recurred. The symptom score changed 10.51 to 2.85. In antibiotics with external sphincter relaxant, the symptom score changed 12.39 to 3.96. In five (16.1%) of them symptoms were recurred and 3 of 5 patients underwent urethral dilatation. In antibiotics with biofeedback, average frequency changed from 12.2 to 7.7 times a day and nocturia changed 2.4 to 0.6 time a night. The symptom score improved from 15.22 to 4.69 and the overall satisfaction rate was 87.8% (41.5%: very satisfied, 46.3%: satisfied, 12.2%: no response). CONCLUSIONS: Biofeedback and external sphincter relaxant therapy as an alternative therapeutic option are effective and appropriate for the treatment of female urethral syndrome especially in patients who did not respond well to antibiotics. For the better outcomes, selection of the most appropriate therapeutic modality with the diagnostic work up is warranted.
Anti-Bacterial Agents* ; Biofeedback, Psychology ; Diagnosis ; Dilatation ; Electric Stimulation Therapy ; Female* ; Humans ; Lower Urinary Tract Symptoms ; Nocturia ; Surveys and Questionnaires ; Urethral Obstruction