International prostate symptom score - IPSS - AUA as discriminat scale in 400 male patients with lower urinary tract symptoms (LUTS)

Abstract

Objective: This study analyzed the total symptom score, irritative and obstructive domains of IPSS questions regarding quality of life and the urodynamic diagnosis in 400 men with LUTS.Materials and Methods: Four hundred consecutive male patients were prospectively enrolled after being submitted to full urodynamic evaluation and IPSS. Obstructed and non-obstructed patients were compared regarding the symptoms score and quality of life. Results were assessed through Wilcox, ANOVA and Student-t tests.Results: 80.2% were diagnosed as urodynamically obstructed of which 42.4% presented detrusor instability in the filling phase. In obstructed patients there were no statistical difference concerning obstructive or irritative questions from IPSS (p = 0.50). It was not possible either to predict which patients presented detrusor instability based on the questionnaire (p = 0.65). Out of seventy-nine cases unobstructed (19.8%), 65.4% revealed detrusor instability. These cases could not be distinguished from all obstructed men based on the clinical questions measured by IPSS (p = 0.87). Obstructive and irritative questions did not present different indexes than obstructed cases (p = 0.63). Subjective quality of life index did not discriminate obstruction nor it could predict detrusor instability in both groups.Conclusion: Clinical symptoms and quality of life index measured by the IPSS as well as its obstructive and irritative domains do not have discriminating power to predict the presence of infravesical obstruction in males with LUTS, demanding objective tools to demonstrate obstruction.

Nocturia and its impact on health-related quality of life and health care seeking behaviour in German community-dwelling men aged 50 years or older

“…At the 2-year follow-up appointment, men first completed the IPSS questionnaire [4,5] to assess LUTS and nocturia/nocturnal voiding frequency (IPSS Question 7, ranging from 0 [no nocturnal voids] to 5 [five or more nocturnal voids]) and the American Urology AssociationSymptom Problem Index (AUA-SPI [17]) to determine the bother originating from each single symptom listed on the IPSS questionnaire, ranging from 0 to 4. For logistic regression analysis, the results of the individual bother scores were summarized to "no bother" [scores 0 ("not a problem at all") + 1 ("mild problem")] or "bother" [scores 2 ("moderate problem") + 3 ("severe problem") + 4 ("very severe problem")].…”

“…Bother from nocturia usually appears when individuals void ≥2 times per night [3]. Nocturia in men is typically assessed during LUTS work-up, either by taking patients' history or completing validated questionnaires such as the International Prostate Symptom Score (IPSS) which has been designed to address LUTS severity and associated overall symptom bother [4,5].…”

Impact of desmopressin on nocturia due to nocturnal polyuria in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH)

“…Both patients and physicians evaluated the efficacy of desmopressin on a 4-item scale (very good/good/ little/no). Additionally, the International Prostate Symptom Score (IPSS [28,29]), the IPSS nocturia (IPSS-Q7) and IPSS-QoL questions (IPPS-Q8), the International Consultation on Incontinence Questionnaire-Nocturia (ICIQ-N) [30], and the Leeds Sleep Evaluation Questionnaire (LSEQ [31]) were used.…”

Elderly men's quality of life and lower urinary tract symptoms: an intricate relationship

“…Among elderly men, benign prostatic enlargement (BPE) is the main cause of LUTS. Despite criticisms about its discriminatory power to predict infravesical obstruction, the International Prostate Symptom Score (IPSS) is the most used instrument to evaluate LUTS in male patients (1)(2)(3)13). BPE, except in extreme cases, does not pose a major threat to one's physical integrity, but undermines QoL; for most mild and moderate-symptom patients, QoL impairment is the main parameter evaluated on whether treating BPE, and choosing therapeutic methods (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13).…”