title: New Visual Prostate Symptom Score versus International Prostate Symptom Score in Men with Lower Urinary Tract Symptoms: A Prospective Comparision in Indian Rural Population.
abstract: BACKGROUND
  Benign prostrate hyperplasia (BPH) is a leading source of healthcare problem in aging men around the world including India. Both International Prostate Symptom Score (IPSS) and New Visual Prostate Symptom Score (VPSS) are used to assess the lower urinary tracts symptoms (LUTSs) in men. The present study was planned to compare these two scores, IPSS and VPSS in Indian rural men prospectively and their efficacy was compared with urodynamic evaluation of the patients.
  
  
  METHODS
  With Institutional Ethical Committee approval, this study was conducted on 100 patients having LUTS and BPH after obtaining written informed consent. Patients' educational status was noted. All the patients were requested to complete the IPSS and VPSS questionnaire, and they were correlated. The urodynamic study was performed on all the patients with uroflowmeter. Two parameters of uroflowmetry, Qmax(maximum urine flow rate expressed in ml/s) and Qavrg(average urine flow rate expressed in ml/s) were measured and correlated.
  
  
  RESULTS
  Most of the patients (55%) in this study were uneducated. Out of 100 patients, 83% were able to fill the VPSS questionnaire without assistance as compared to only 40% patients in IPSS questionnaire (Z= 6.557,P< 0.001). There was a positive correlation between IPSS and VPSS total score in this study (r= 0.453 andP≤ 0.001). It was noticed that IPSS Question 2 for frequency of urination had a positive correlation with VPSS Question 1 (day time frequency of urination)r= 0.645 (P= 0.000). Similarly, IPSS Question 7 for night frequency when compared with VPSS Question 2 (nocturia); the value forrwas found to be 0.536 (P= 0.000). The IPSS Question 5 for straining when compared to the VPSS Question 3, i.e., the question for the strength of stream during micturition; the positive correlation was found to be 0.266 (P= 0.007). There was a negative correlation between IPSS total score and Qavrgwith value - 0.368 (P= 0.000) and between IPSS total score and Qmaxof - 0.433 (P= 0.000). A negative correlation is also noted between VPSS total score and Qavrgof value 0.497 (P= 0.000) and VPSS total score and Qmaxof value - 0.719 (P= 0.000).
  
  
  CONCLUSIONS
  VPSS correlates significantly with the IPSS to quantify the LUTS due to BPH. The VPSS can be used instead of the IPSS for the assessment of symptom severity in men with LUTS, who are illiterate or have limited education.
authors.affiliation: Department of Surgery, Adesh Institute of Medical Sciences, Bathinda, India.
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Roy
authors.affiliation: Department of Surgery, GGS Medical College and Hospital, Faridkot, Punjab, India.
authors.forename: Amandeep
authors.initials: A
authors.lastname: Singh
authors.affiliation: Department of Surgery, GGS Medical College and Hospital, Faridkot, Punjab, India.
authors.forename: Darshan Singh
authors.initials: DS
authors.lastname: Sidhu
authors.affiliation: Department of Surgery, GGS Medical College and Hospital, Faridkot, Punjab, India.
authors.forename: R P
authors.initials: RP
authors.lastname: Jindal
authors.affiliation: Department of Medicine, Adesh Institute of Medical Sciences, Bathinda, India.
authors.forename: Mishi
authors.initials: M
authors.lastname: Malhotra
authors.affiliation: Department of Anaesthesia and Intensive Care, GGS Medical College and Hospital, Faridkot, Punjab, India.
authors.forename: Haramritpal
authors.initials: H
authors.lastname: Kaur
keywords: Benign prostrate hyperplasia; lower urinary tracts symptoms; symptom scores; uroflowmetry