Background: Lower urinary tract symptoms (LUTSs) are among the most common urological complaints in older men, frequently arising from benign prostatic hyperplasia (BPH) or prostate cancer (PCa). While both conditions share overlapping symptomatology, the way each condition progresses and is managed differs considerably. In sub-Saharan Africa, data on the relative burden of BPH and PCa among men presenting with LUTSs are scarce. This study aimed to determine the prevalence of histologically confirmed BPH and PCa among men presenting with LUTSs at a major tertiary referral center in Tanzania and to explore the association between specific urinary symptoms and histopathological diagnoses. Methods: A retrospective cross-sectional study was conducted at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania, reviewing medical records of adult male patients aged ≥50 years who presented with LUTSs and underwent prostatic biopsy between January and December 2023. A total of 133 patients were included through simple random sampling from an eligible population of 260. Data on demographics, comorbidities, International Prostate Symptom Score (IPSS), serum prostate-specific antigen (PSA), prostate volume, and histopathological biopsy outcomes were extracted using a purpose-built digital form. This study was conducted in compliance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results: Most patients (39.8%) were aged 70 to 79 years. Hypertension was the most frequent comorbidity among those with chronic disease (31.65%), followed by diabetes mellitus (12.03%). The mean serum PSA was 465.1 ng/mL (SD = 1610.1), and the mean prostate volume was 80.6 cm[3] (SD = 75.6). Histopathologically, 57.9% of biopsies were benign and 40.6% were malignant. The most commonly reported IPSS symptoms were urinary frequency (78.2%), weak stream (78.2%), and incomplete emptying (64.7%). Most patients (59.4%) had severe IPSSs. Statistically significant associations were observed between biopsy outcomes and incomplete emptying (p = 0.011), frequency (p = 0.014), weak stream (p = 0.022), nocturia (p = 0.001), urge incontinence (p = 0.004), and post-void dribbling (p < 0.001). IPSS severity was significantly associated with biopsy diagnosis (p < 0.001), with 63% of malignant cases presenting with moderate symptom scores. Conclusions: BPH was the predominant histopathological diagnosis among men presenting with LUTSs at this tertiary center, while prostate cancer accounted for a substantial minority of cases. Certain individual LUTSs, particularly nocturia, urge incontinence, and post-void dribbling, demonstrated significant associations with malignant histopathology. These findings underscore the necessity for systematic histopathological evaluation in all men presenting with LUTSs in resource-limited settings, irrespective of symptom severity.

Overactive bladder (OAB) is a urological syndrome characterized by urinary urgency, frequency, nocturia, and, in some cases, urge incontinence in the absence of infection or other identifiable pathology. It can significantly impair health-related quality of life (HRQoL) through physical discomfort, psychological distress, and social embarrassment. This study aimed to compare the prevalence of OAB and its impact on HRQoL among medical and nonmedical university students in Pakistan. A comparative cross-sectional study was conducted between February and October 2025 among 418 university students (217 medical and 201 nonmedical) recruited through convenience sampling. Data were collected using self-administered questionnaires, including the Overactive Bladder Awareness Tool, the Perception of Academic Stress Scale, and the International Consultation on Incontinence Questionnaire-Overactive Bladder Module. Statistical analysis was performed using SPSS version 22. Chi-square tests were used for categorical variables, independent t tests for group comparisons, ANOVA for differences across academic years, and logistic regression to identify independent factors associated with OAB. A P-value < .05 was considered statistically significant. OAB symptoms were reported by 23.2% of students. Smoking was significantly associated with OAB (50% in smokers vs 21.4% in nonsmokers, P = .002). In logistic regression analysis, smoking (odds ratio = 0.334, P = .029) and greater HRQoL impact (odds ratio = 1.16, P = .004) were independently associated with OAB. OAB severity scores were positively correlated with HRQoL impairment (ρ = 0.234, P < .001). Despite the burden of symptoms, only 11.7% of affected students sought medical care, while medical students demonstrated greater awareness of treatment options compared with nonmedical students (P = .046). Nearly 1 in 4 university students experienced OAB symptoms, which were associated with significant impairment in HRQoL but remained largely underrecognized and undertreated. This highlights a substantial gap between symptom burden and healthcare-seeking behavior, underscoring the need for targeted awareness, lifestyle modification, and improved access to care in university settings.

Overactive bladder (OAB) is a common urological condition with significant impacts on quality of life and healthcare burden. Chronic inflammation and insulin resistance have been independently linked to bladder dysfunction. The C-reactive protein-triglyceride glucose index (CTI), a novel composite marker reflecting both inflammatory and metabolic status, may provide additional value in assessing OAB risk, but has not been previously studied in this context. We conducted a cross-sectional analysis using data from National Health and Nutrition Examination Survey 2005-2010 and 2015-2018. OAB was defined based on self-reported symptoms of urgency incontinence and nocturia. CTI was calculated as 0.412 × ln (CRP) + TyG, where TyG = ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Survey-weighted multivariable logistic regression models were used to assess the association between CTI and OAB. Subgroup, interaction, and generalized additive model analyses were performed to explore potential effect modification and nonlinear trends. Discriminative performance was evaluated using receiver operating characteristic curves. A total of 9390 adults were included. Higher CTI levels were significantly associated with increased odds of OAB. In fully adjusted models, each unit increase in CTI was associated with a 17% higher risk of OAB (OR = 1.17, 95% CI: 1.06-1.28, P = .002). Compared to the lowest CTI quartile, the highest quartile showed a 50% increased risk of OAB (OR = 1.50, 95% CI: 1.17-1.93, P = .002). The association persisted across subgroups, with stronger effects observed in females, younger adults, and participants with lower poverty income ratio. Interaction tests confirmed significant effect modification by age (P for interaction < .001) and socioeconomic status (P = .02). Generalized additive model analysis demonstrated a nonlinear positive trend between CTI and OAB prevalence. In receiver operating characteristic analysis, CTI showed superior discriminative ability (AUC = 0.607) compared to CRP (AUC = 0.588) and TyG (AUC = 0.569). CTI is independently associated with the presence of OAB in a representative US adult population. As a composite marker of metabolic and inflammatory burden, CTI may serve as a useful tool for identifying individuals at elevated risk of OAB, particularly among younger and socioeconomically disadvantaged groups.

Aim of this review is to evaluate the pharmacological efficacy and safety of Serenoa repens extracts in managing lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). Using PubMed, Web of Science, and the Cochrane database, we identified studies published until November 2023 reporting effect of Serenoa repens extracts on LUTS and BPH. All studies were included in the literature search. The most relevant studies were selected to identify the effects of different extracts of serenoa repens in terms of pharmacology, efficacy and safety. Hexanic extract of Serenoa repens (HESr), presents important anti-inflammatory, antiproliferative, and antiandrogenic activities proven through various in vitro, in vivo, and clinical trials. The current phytotherapeutic landscape is very heterogeneous and limited by the lack of a regulatory framework for herbal substances. There is a clear disparity in the qualitative and quantitative composition of extracts due to varied extractive processes, affecting the therapeutic efficacy. Several studies (prospective randomized clinical trials) demonstrated the clinical efficacy of HESr compared to placebo and other pharmacological treatments. Particularly, HESr improves nocturia and Qmax. Other extraction techniques, such as alcoholic and CO<inf>2</inf> need further RCT to better define their efficacy. The review identifies the critical role of Serenoa repens extract in managing LUTS in patients with BPH. Particularly the evidence suggests significant in vitro and in vivo differences in terms of inflammation reduction, symptoms relief and flow improvement depending on the extraction technique.

This narrative review explores the complex relationship between lower urinary tract symptoms (LUTS) and mental health disorders, focusing on the influence of anxiety and depression on bladder function. Historical perspectives highlight early psychoanalytic theories, with renewed research underscoring the link between psychiatric conditions such as anxiety, depression, and obsessive-compulsive disorder (OCD), which is closely related to anxiety and various LUTS, including urinary incontinence (UI), overactive bladder (OAB), voiding dysfunction, and nocturia. Although the exact causal mechanisms remain unclear, the association between LUTS and mental health disorders is complex, involving shared neurological, neurochemical, and inflammatory pathways. The bladder-brain axis (BBA) explains how psychological stressors and physical threats contribute to alarm falsification, enhancing symptom severity and distress. There is a bidirectional relationship between mental health disorders and LUTS which emphasizes the need for a multidisciplinary approach to diagnosis and treatment. Especially because mental health disorders can significantly worsen treatment outcome and treatment adherence. Finally, this review highlights promising directions for future research, including the use of emerging approaches such as artificial intelligence (AI) and ecological momentary assessment (EMA). These tools offer potential for real-time monitoring and personalized treatment, addressing the limitations of retrospective assessment and improving patient care.