204 Randomized controlled study of the efficacy and safety of continuous saline bladder irrigation after transurethral resection for the treatment of non-muscle invasive bladder cancer

Abstract

INTRODUCTION AND OBJECTIVES: Genitourinary diseases may increase the risk of depression. However, the magnitudes of these associations are unclear. To clarify the available evidence, we analyzed self-reported urologicand depressive-symptom questionnaire data from the 2005-2012 National Health and Nutrition Examination Survey (NHANES). METHODS: We analyzed the responses of 2005-2012 NHANES participants who completed surveys on kidney failure, urolithiasis, and lower urinary tract symptoms (e.g., frequency, leakage, and nocturia) and depression (assessed using the nine-item Patient Health Questionnaire, or PHQ-9). Urologic-symptom variables were examined in sample-weighted linear regression models for associations with depressive symptoms. Models were adjusted for potential confounders including age, sex, body-mass index, alcohol intake, tobacco use, income-to-poverty ratio, physical activity, and the presence of medical comorbidities. Statistical significance was defined as a twotailed P < 0.05. RESULTS: Survey data from 5,009 men and 5,278 women with a median age of 49 years (range: 20 to 85) were analyzed. On multivariate analysis, self-report of urine leakage at rest, during physical activity, before reaching the toilet, at night, or at any time was significantly associated with increased depressive symptoms (quantitative results are shown in the Figure). Self-report of weak or failing kidneys was similarly associated with increased depressive symptoms. Urolithiasis was not significantly associated with depressive symptoms. CONCLUSIONS: In this analysis, potentially clinically important independent associations between genitourinary and depressive symptoms were identified. Further studies are needed to determine the importance of these results with regard to screening for or treating depression in the urology clinic.