Comparison of the visual prostate symptom score with the international prostate symptom score in men with lower urinary tract symptoms.

Abstract

Background: LUTS predominantly due to BPH, pose tremendous morbidity in men above 50. Accurate clinical assessment of these LUTS is crucial in planning treatment and patient follow up. The IPSS is the universally accepted clinical assessment tool. However, patients with low education levels and the illiterate cannot self-administer the tool accurately. There is a justifiable need therefore to devise a simpler tool for this category of patients, which the new VPSS promises to be. Objective: To examine the extent to which the VPSS and the IPSS agree or differ in assessing LUTS. Methods: The study was cross sectional, conducted on a consecutively sampled population of men with LUTS, attending the Urology clinic of Mulago Hospital. All patients completed both the VPSS (by self-administration) and IPSS Questionnaire (investigator-administered). Correlations between VPSS and IPSS scores were computed using Spearman’s rank correlation test, while percentage agreement in parameter scores was done by Bland-Altman analysis. Sensitivity and specificity of the VPSS as measured against the IPSS were determined using the student’s t-test of the Wilcoxon Rank test. Results: A total of 70 men were enrolled between August 2012 and January 2013, 70% of whom were severely symptomatic (IPSS ≥19). Majority had limited education; 60% of them had only primary education or none. The correlation between Total VPSS with the Total IPSS scores was+0.57, and the two tools exhibited a significantly high level of agreement in assessing corresponding parameters, the highest being with Nocturia (91.4%). The VPSS scale was calibrated against the IPSS, such that at a cut-off point between 11 and 12, severely symptomatic patients can be differentiated from the Non-severely symptomatic with a sensitivity of 82% and specificity of 57%. Conclusion: There is a significant positive correlation between VPSS and IPSS scores.