Volume 17, Number 2Review ArticlesRelationship Between Depression and Lower Urinary Tract Symptoms Secondary to Benign Prostatic HyperplasiaMangement UpdateSteven A KaplanLeanna LaorClaire DunphyBilal ChughtaiAlexis E TeThis article provides an overview of current data on the relationship between depression and lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), with a focus on pathophysiology and patient management implications. Review of the literature indicated a clear relationship between LUTS secondary to BPH and depression. It is unknown whether this relationship is bidirectional or unidirectional. Depression is associated with the impact of LUTS on quality of life in men with BPH. Research suggests that depression alters the experience of LUTS in this population. Medical and surgical treatments for BPH may impact quality of life and, therefore, depression. Results conflict on the exact nature of the relationship examined, and on the extent to which the relationship may be attributed to physiological factors such as inflammation. Practicing clinicians should consider using a brief self-administered scale to assess for depression in patients with BPH. There is a clear need for additional research to decisively determine the nature of the relationship between LUTS secondary to BPH and depression, as well as the extent to which change in either condition may be affected by the other. [Rev Urol. 2015;17(2):51-57 doi: 10.3909/riu0658] © 2015 MedReviews®, LLCBenign prostatic hyperplasiaDepressionLower urinary tract symptoms
Volume 21, Number 2Review ArticlesPrimary Bladder Neck ObstructionDisease State ReviewBenjamin M BruckerAlice DrainRachael D SussmanPrimary bladder neck obstruction (PBNO) is a functional obstruction caused by abnormal opening of the bladder neck during the voiding phase of micturition. PBNO may present with a variety of symptoms including voiding symptoms (slow urinary stream, intermittent stream, incomplete emptying), storage symptoms (frequency, urgency, urgency incontinence, nocturia), and/or pelvic pain and discomfort. The diagnosis of PBNO can be made with videourodynamic testing, which demonstrates elevated voiding pressures with low flow, and fluoroscopic imaging demonstrating obstruction at the level of the bladder neck. Treatment options include conservative management with watchful waiting, pharmacologic management, and surgical intervention. In this article, we review the etiology, presentation, diagnosis, and treatment of PBNO in men, women, and children. [Rev Urol. 2019;21(2/3):53–62] © 2019 MedReviews®, LLCLower urinary tract symptomsBladder outlet obstructionPrimary bladder neck obstruction