[The role of the IPSS (International Prostate Symptoms Score) to evaluate the frequency of disability induced by each of the 7 symptoms. (CTMH-AFU study)].
BACKGROUND
Evaluation of a patient with voiding disorders related to benign prostatic hyperplasia is theoretically performed by means of the IPSS score, which comprises only one global quality of life question. This study used a questionnaire to evaluate the frequency of disability induced by each of the symptoms of the IPSS in a representative sample of the French population and then proposed a weighting of the IPSS score by the statistical weight of disability of each symptom without having to increase the number of questions.


METHODS
A survey on the voiding behaviour of French men was performed by TNS Sofres Healthcare by questionnaire between 18/4/03 and 27/5/03 in a panel of 3877 men aged 50 to 80 years representative of the French population. This survey comprised demographic and sociological questions as well as the IPSS score. A specific question concerning the disability induced by each of the 7 symptoms ("Does it bother you enormously, a lot, slightly, not at all? ") was added.


RESULTS
Each symptom induced a different type of disability: the most marked disability was induced by urgent micturition and uri nary frequency, while interrupted stream only had a minor impact. Statistical modelling was performed to obtain a coefficient for each level of frequency of the symptom, directly integrating the theoretical statistical weight of the specific disability. With this statistical method, the frequency of each of the 7 symptoms was weighted by a coefficient from 0.00 to 1.54 according to the disorder and its frequency. A total of 35 coefficients were necessary to construct the score as a function of the frequencies of disability of the 7 symptoms. This method was used to classify disorders according to the degree of disability that they induced, the most disabling being urgency (from 0 to 1.54), followed by straining to urinate (0 to 1.17), and then each of the other 5 symptoms.


CONCLUSIONS
The original feature of this new score is that it directly integrates the frequency and theoretical specific disability of each of the 7 symptoms of the IPSS score. However, it needs to be validated by a prospective clinical trial.
de la Taille
Alexandre
A
Service d'Urologie, Hôpital Henri Mondor Créteil, France. adelataille@hotmail.com
Desgrandchamps
François
F
Haillot
Olivier
O
Saussine
Christian
C
Lukacs
Bertrand
B
Marc
Fourmarier
F
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000150:complications*; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014555:Urination Disorders / Q000209:etiology*