When Psychiatry Meets Lipids: A case of severe hypertriglyceridemia in long-standing schizophrenia identified through a specialized metabolic clinic.

Bladder function comprises low-pressure urine storage followed by efficient emptying, which depends on coordinated detrusor contraction with synchronous relaxation of the urethral sphincter and pelvic floor [, ]. This process is regulated by central and peripheral neural mechanisms, autonomic sensory afferents, neurotransmitters, and the structural integrity of the lower urinary tract []. Failure of coordinated relaxation of the urethral sphincter and pelvic floor during voiding may result in functional bladder outlet obstruction (BOO), progressive bladder remodeling, impaired detrusor contractility, and ultimately upper urinary tract deterioration [–]. Dysfunctional voiding (DV) is a common lower urinary tract dysfunction in children, ranging from mild functional alterations to complex conditions affecting the upper urinary tract. The most severe clinical phenotype, historically described as Hinman syndrome (HS), is characterized by functional bladder outlet obstruction in neurologically normal children, resulting in vesicosphincter discoordination, progressive bladder dysfunction, and potential upper urinary tract deterioration [, , ]. The therapeutic management of DV remains challenging, and no consensus exists regarding the optimal treatment strategy. Conservative treatment, including bladder retraining, pharmacotherapy, and biofeedback, constitutes the first-line approach [, ]. Patients refractory to conservative management may require botulinum toxin injection, sacral neuromodulation, or reconstructive surgery [, , ]. Therefore, less invasive therapeutic alternatives that can improve bladder function are needed.