Published online Aug 19, 2026. doi: 10.5498/wjp.119137
Revised: March 30, 2026
Accepted: May 27, 2026
Published online: August 19, 2026
Processing time: 134 Days and 9.2 Hours
Benign prostatic hyperplasia (BPH) - that’s BPH, by the way - is a pretty serious problem for older guys when it comes to their bladders. Surgery is the primary treatment for patients with moderate-to-severe symptoms. However, psychological comorbidities after surgery can cause some patients to experience decreas
To help find out what happens in the long-term with pee after surgery for prosta
In this investigation, past information was gathered from 756 sufferers of BPH who had undergone surgical procedures at Wuxi Ninth People’s Hospital Affiliated to Soochow University, and the Second Affiliated Hospital of Nanjing Medical University, from January 2021 to January 2025. Patients were divided into two groups based on the presence of depression: Comorbidity (n = 65) and non-comorbidity (n = 691). The two groups were compared at 6 months and 12 months after surgery in terms of their demographic and clinical characteristics, how well they took their medication, and their urinary function. We used a special type of maths to work out what causes people to take their medicine. We also used a special type of maths to see how depression affects people’s ability to pee.
Patients with depression and comorbidities showed significantly lower medication adherence self-efficacy, more missed doses and follow-up visits, and poorer health behaviors than those without depression (P < 0.05). They also had higher International Prostate Symptom Score and lower Quality of Life scores at 6 and 12 months postoperatively, along with lower maximum flow rate and higher post-void residual urine volume (P < 0.05). Improvement in urinary function was less marked in depressed patients. Multivariate analysis identified depression [odds ratio (OR) = 3.215, 95% confidence interval (CI): 1.892-5.463)], age ≥ 70 years (OR = 2.108, 95%CI: 1.276-3.482), and primary education or below (OR = 1.983, 95%CI: 1.195-3.294) as independent risk factors for poor adherence. Hamilton Depression Rating Scale scores correlated positively with International Prostate Symptom Score, Quality of Life, and post-void residual urine volume, and negatively with maximum flow rate (P < 0.001).
The study found that depression can make it harder to stick to treatment and can also make it take longer to recover from surgery for BPH. The study also found that the more severe the depression, the less likely the patient is to recover well. The findings emphasise the significance of conducting depression screenings at the outset and of implementing comprehensive interventions for BPH patients who also have depression. This approach is intended to enhance adherence to treatment and to ensure the best possible postoperative urinary outcomes.
Core Tip: This retrospective study found that comorbid depression is an independent predictor of poor treatment adherence among patients undergoing surgery for benign prostatic hyperplasia. Reduced adherence was associated with impaired long-term recovery of urinary function after surgery. These findings highlight the importance of routine psychological assessment and early identification of depressive symptoms in this patient population. Implementing targeted psychological and behavioral interventions may improve treatment compliance, enhance postoperative recovery outcomes, and support long-term urinary function rehabilitation in patients with benign prostatic hyperplasia.