This review critically evaluates recent literature from the past five years concerning the management of lower urinary tract symptoms (LUTS) in patients with multiple sclerosis (MS), highlighting advances in understanding disease mechanisms, diagnostic strategies, and therapeutic options.

Cerebral cysticercosis (CC), a neglected tropical disease of the central nervous system caused by Taenia solium larvae, is rarely associated with hydrocephalus in its parenchymal form. We report a 45-year-old male with a 20-year progressive course of cognitive decline, gait instability, urinary incontinence, and recurrent seizures. Epidemiological history included long-term rural residence, close contact with free-roaming domestic pigs, poor household sanitation, lack of standardized latrine use, and unsafe human feces disposal in the endemic region, together with consumption of undercooked pork two decades prior. Neuroimaging revealed multiple ring-enhancing parenchymal cysticercal lesions in the left frontal lobe, bilateral parietal lobes, right periventricular region, and right cerebellar hemisphere. The lesions were strictly parenchymal, periventricular, and adjacent to but not inside the third ventricle, with formation of a cerebral aqueductal septum, impaired cerebrospinal fluid (CSF) circulation, and supratentorial ventricular dilatation. The patient underwent ventriculoperitoneal (VP) shunting combined with staged albendazole therapy and antiepileptic treatment, achieving significant symptomatic improvement and seizure-free survival at one-year follow-up. This case underscores the unique pathogenesis of aqueductal septum formation in parenchymal neurocysticercosis, supports the efficacy of combined surgical and medical intervention in chronic presentations, and adds to the scarce literature on this rare comorbidity.

Background. Older adults in low- and middle-income countries are increasingly affected by both chronic-disease multimorbidity (MM) and geriatric syndromes (GS), but evidence on their joint impact on subjective well-being from the Indian subcontinent is limited. We examined the prevalence of MM and GS, and quantified their independent and joint associations with life satisfaction, in a nationally representative sample of older Indians. Methods. We conducted a cross-sectional analysis of Wave 1 of the Longitudinal Ageing Study in India (LASI, 2017-18), restricted to community-dwelling adults aged 60 years or older (n = 30,811 with complete data on key variables; weighted mean age 68.6 years, SD 7.3). Multimorbidity was defined as two or more of nine self-reported physician-diagnosed chronic conditions. Geriatric syndromes were defined as the presence of at least one of seven syndromes: cognitive impairment (general cognitive factor score below the 10th weighted percentile), hearing impairment, vision impairment (poor self-rated near or distance vision), falls in the past 2 years, urinary incontinence, depression (Center for Epidemiologic Studies Depression-10 score ≥ 4 symptoms), and underweight (body-mass index < 18.5 kg/m[2]). Life satisfaction was measured using the 5-item Satisfaction with Life Scale (SWLS). All analyses applied LASI individual analysis weights. Associations were estimated using sequentially adjusted weighted linear regression with sandwich-estimator standard errors. Results. The weighted prevalence of MM was 23.4 % and of any GS 70.5 %. State-level MM prevalence ranged from 4.1 % in Arunachal Pradesh to 55.7 % in Kerala. After full adjustment, the presence of any GS was associated with a 2.36-point lower life satisfaction score (95 % CI - 2.61 to - 2.11; p < 0.001), with a clear dose-response by GS count (1 GS: β = - 1.52; 2 GS: β = - 2.89; ≥ 3 GS: β = - 4.33; all p < 0.001). In contrast, MM was not independently associated with life satisfaction in the adjusted model (β = + 0.08; 95 % CI - 0.33 to + 0.49; p = 0.71), nor was the MM × GS interaction term (β = - 0.19; 95 % CI - 0.69 to + 0.30; p = 0.44). Higher education, greater wealth, co-residence with family, urban residence, and female sex were independently associated with higher life satisfaction. Findings were robust to a sensitivity analysis excluding depression from the GS composite (GS β = - 1.48; 95 % CI - 1.72 to - 1.23). Conclusions. In community-dwelling older Indians, geriatric syndromes, not multimorbidity are the principal correlate of reduced life satisfaction, with a graded dose-response by number of syndromes. Primary-care programmes for older adults in India, including the National Programme for Health Care of the Elderly and the Ayushman Bharat Health and Wellness Centres, should prioritise structured screening and management of geriatric syndromes alongside chronic-disease care, particularly in rural and lower-wealth populations where GS prevalence is highest but specialist access is most limited. Trial registration: Not applicable. This study is a secondary analysis of observational survey data and did not involve a health-care intervention.

Fowler's Syndrome is a critically under-researched area of Women's Urological health. The condition, which causes severe urinary retention in the absence of any obvious obstructive pathology, lacks any non-invasive options for treatment. Transcutaneous Tibial Nerve Stimulation (TTNS) is an established treatment strategy for disorders of incontinence that is non-invasive, safe, and efficacious. Computer based modelling and preliminary animal experimentation indicates that ultra-low frequency TTNS (1-2 Hz) may induce an excitatory effect on bladder function that is of particular therapeutic relevance to Fowler's Syndrome. Therefore, the present case series describes a three-armed randomised-control (crossover) pilot study conducted from a biomechanical perspective in a population suffering from Fowler's Syndrome. The study aimed to address the question of if the novel application of low-frequency TTNS could ameliorate the symptoms of Fowler's Syndrome. Patients (N = 6) were administered either ultra-low frequency TTNS (1 Hz) or placebo. The objective outcome measure of the study was the change in voiding efficiency in response to intervention. 50% (N = 3) participants displayed a positive response to treatment, with a median increase in Voiding Efficiency of 6.3 to 12.6% across test conditions. Two participants displayed a negative response to the intervention, (median -3.6 to -20.9%) which may have been due to placebo effects but should be considered in future. The study indicated that TTNS may be capable of ameliorating the symptoms of Fowler's Syndrome, to a significant degree in one case. The work provides a foundation for future clinical research. The authors hope that should the results be confirmed by further clinical study they will have considerable impact on patient care.

Aging is accompanied by profound changes in bladder function, leading to increased urinary frequency and incontinence that impair quality of life in humans and are recapitulated in mouse models. Bladder filling and emptying rely on precise mechanosensory feedback, yet how aging alters this sensory control remains unclear. PIEZO ion channels convert mechanical forces into cellular signals essential for bladder fullness sensation. Using inducible smooth-muscle specific Piezo1 deletion, we find that loss of Piezo1 attenuates aging-related bladder dysfunction. Dietary enrichment with margaric acid, a membrane-active fatty acid previously shown to inhibit PIEZO channels, reduced urinary dysfunction in aged mice. In humans, genotype-phenotype analyses reveal an association between a PIEZO1 gain-of-function variant and early-onset neuromuscular bladder dysfunction. Together, these findings define a smooth-muscle, PIEZO1-mediated mechanosensory basis for aging-related bladder dysfunction and introduce a non-invasive strategy for targeting PIEZO channels in vivo .

Male genital lichen sclerosus (MGLSc) is a chronic inflammatory dermatosis with significant morbidity, yet its pathogenesis remains incompletely understood. Two main hypotheses have emerged: an autoimmune model, and the urine/occlusion hypothesis, specific to male genital anatomy. This narrative review critically analyses evidence supporting each paradigm. Epidemiological data reveal that autoimmune comorbidities occur significantly less frequently in men with MGLSc than in women with vulvar disease, with some studies reporting prevalence no higher than general population rates. Histopathologically, cytotoxic CD8+ and CD57+ T-lymphocyte infiltration suggests immune-mediated tissue injury, yet extracellular matrix protein 1 autoantibodies show no significant seroreactivity in males. Conversely, the urine/occlusion hypothesis is supported by the near-universal association of MGLSc with intact foreskin, high prevalence of post-micturition micro-incontinence, anatomical mapping demonstrating disease concentration in maximally occluded preputial regions, and case series showing disease resolution following urinary diversion and induction at urostomy sites. Microbiome studies demonstrate convergence between balanopreputial and urinary microbial communities in affected patients, while molecular evidence shows urea-induced fibroblast changes consistent with fibrogenesis. Recent transcriptomic analyses identifying distinct molecular subtypes suggest heterogeneity, with autoimmune mechanisms potentially operative in only a subset of patients. The evidence reviewed supports urine exposure and occlusion as the predominant pathogenic drivers in most MGLSc cases, with autoimmune phenomena likely representing secondary responses to tissue injury rather than primary etiological mechanisms.