Comparative study of international prostate symptom scores and urodynamic parameters in men and women with lower urinary tract symptoms

Diagnostic value of voiding scores of the "International prostate symptom score" and the "Bristol female lower urinary system symptoms-short form" questionnaires in women with voiding dysfunction

Introduction

We aimed to investigate the diagnostic value of International Prostate Symptom Score voiding symptom score (IPSS-VS) and Bristol Female Lower Urinary Tract Symptoms-short form voiding score (BFLUTS-VS) in female patients with urodynamically diagnosed voiding dysfunction.

Methods

The medical records of female patients who underwent urodynamic examination between May 2007 and November 2021 for lower urinary tract complaints were retrospectively evaluated. A total of 1858 female patients were included in the study. Patients investigated between 2007 and 2014 were asked to fill the IPSS, and patients investigated after 2015 were asked to fill the BFLUTS-SF.

Results

The mean age of the patients was 49.06 ± 0.33 in the IPSS group and 50.02 ± 0.47 in the BFLUTS group. On the pressure flow study, voiding dysfunction was found in 14.8% (n = 95) in the IPSS group and 15.1% (n = 183) in the BFLUTS group. The area under curve value was found to be 0.58 for IPSS and 0.64 for BFLUTS. Threshold values were found as >9 for IPSS-VS and >4 for BFLUTS-VS. The sensitivity, specificity, false negative, and false positive rates for IPSS-VS were 33.3%, 78.8%, 66.7%, and 21.2%, respectively. The same parameters were 45.5%, 78.9%, 54.5%, and 21.1% for BFLUTS-VS, respectively.

Conclusion

The diagnostic performance of both the questionnaires was found to be low for diagnosing voiding dysfunction in female patients according to our data. Therefore, the assessment of the voiding phase in women should not solely rely on the current questionnaires. However, further studies using questionnaires including all voiding symptoms are required.

The health-related quality of life of Chinese patients with lower urinary tract symptoms in primary care

PURPOSE

The aim of this study was to evaluate the health-related quality of life (HRQOL) of Chinese primary care patients with lower urinary tract symptoms (LUTS).

METHODS

Five hundred and nineteen primary care subjects with LUTS completed a structured questionnaire containing the International Prostate Symptom Score, the adapted Incontinence Impact Questionnaire-7, the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, the Chinese (HK) SF-12 Health Survey Version 2 (SF-12 v2) and the Depression, Anxiety and Stress Scale-21.

RESULTS

LUTS patients had poorer HRQOL for the General Health and the Vitality domains and lower Physical Component Summary scores, but better HRQOL for the Role Emotion domain than the adjusted Hong Kong population norms. Clinical factors associated with poorer HRQOL measured by the SF-12 v2 included having more severe LUTS and having more severe depressive, anxiety and stress symptoms. Socio-demographic factors associated with poorer SF-12 v2 were consistent with those found in the general populations. Clinical and socio-demographic factors associated with poorer HRQOL assessed by condition-specific measures included having more severe LUTS (excluding intermittency and straining), the presence of mixed urinary incontinence, having more severe anxiety and stress symptoms, younger age, being not married, being in employment and having a lower household income.

CONCLUSIONS

LUTS had substantial negative impact on patients' overall health perception and global well-being in Chinese population. A decline in HRQOL might be a key determinant for Chinese patients with LUTS to seek treatment. Patients with nocturia, frequency, urgency or mixed urinary incontinence and younger patients deserve more treatment attention because they appear to have poorer HRQOL.

Objective Evaluation of Overactive Bladder: Which Surveys Should I Use?

Overactive bladder (OAB) is a common condition that affects many adults, and prevalence increases with age in both men and women. It is characterized by symptoms of urinary frequency and urgency with or without urge incontinence in the absence of another proven etiology. As a diagnosis based solely on urinary symptoms, proper evaluation of OAB often depends on the use of psychometrically validated questionnaires to assess symptom severity and degree of bother. General urinary assessment forms can evaluate many urinary symptoms while modular questionnaires can focus on the most bothersome complaints. Many questionnaires have been formulated and validated to achieve these goals. Currently, the ideal questionnaire does not exist. This review attempts to outline the range of questionnaires available to the clinician to assist in evaluating symptoms as well as degree of impact on quality of life.