LACK OF CORRELATION OF THE AMERICAN-UROLOGICAL-ASSOCIATION SYMPTOM-7 INDEX WITH URODYNAMIC BLADDER OUTLET OBSTRUCTION

The objective of this study is to assess whether subjective informatio n from the American Urological Association (AUA) Symptom 7 Index corre lates with or predicts objective urodynamic parameters of bladder outl et obstruction. Seventy-five men, mean age 67 years (range 42-85 years ), were referred for evaluation of ''prostatism.'' Evaluation consiste d of the AUA Symptom 7 Index, noninvasive uroflow, post-void residual (PVR) urine measurement, and pressure-flow analysis. Men were categori zed as ''obstructed,'' ''equivocal,'' or ''unobstructed'' according to the pressure-flow nomogram of Abrams and Griffiths. The total AUA 7 s core, and all individual components, were compared with all invasive u rodynamic parameters, and to the pressure-flow categories of obstructe d, equivocal, or unobstructed. The AUA index severity categories (mild 0-7, moderate 8-19, and severe greater than or equal to 20) were comp ared to the urodynamic pressure flow categories. Thirty-three men had severe symptoms, and 42 had moderate or mild symptoms. Forty men were urodynamically obstructed, and 35 men were equivocal or unobstructed. There was no correlation of any AUA index parameter (total symptom sco re, obstructive or irritative score component, or any individual quest ion) with any noninvasive or invasive urodynamic parameter. The sensit ivity and specificity of the AUA index for urodynamic obstruction was 42.5% and 54.3% respectively. Multivariable logistic regression analys is was used to determine whether clinical data easily obtained in the office setting (age, PVR, noninvasive maximum and average flow rates) could predict urodynamic obstruction when combined with any component of the AUA index. Only age was found to be a significant predictor of obstruction status (P = 0.026). Subjective information from the AUA Sy mptom 7 Index does not correlate with objective data assessing bladder outlet obstruction. Though the AUA index is a valid clinical tool, it should not be used to gauge the presence or severity of bladder outle t obstruction. (C) 1996 Wiley-Liss, Inc.