SIGNIFICANT CORRELATION OF THE AMERICAN-UROLOGICAL-ASSOCIATION SYMPTOM SCORE AND A NOVEL URODYNAMIC PARAMETER - DETRUSOR CONTRACTION DURATION

Purpose: Various investigators have reported the lack of specificity o f the American Urological Association (AUA) symptom score and its poor correlation with urodynamic parameters, A retrospective study was per formed to ascertain the correlation of the AUA symptom score with vari ous urodynamic parameters, including detrusor contraction duration. Ma terials and Methods: The urodynamic records of 120 consecutive patient s with moderate (scores 8 to 19) or severe (scores greater than 19) sy mptoms were retrospectively analyzed to ascertain if the AUA symptom s core correlated with the urodynamic parameters of maximum detrusor pre ssure, detrusor pressure at maximum flow, compliance, involuntary detr usor contractions and, a novel parameter, detrusor contraction duratio n. Results: There were 63 men (mean age 59.7 years) and 57 women (mean age 58.8 years). Mean AUA symptom score plus or minus standard deviat ion was 17.8 +/- 3.7 and 15.4 +/- 2.9, respectively. There was no corr elation between any urodynamic parameter and symptoms in women, In men increasing symptoms were associated with worsening urodynamic paramet ers. The 2 parameters that had the greatest correlation with symptom s everity were incidence of involuntary detrusor contractions (r = 0.56, p <0.006) and detrusor contraction duration (r = 0.61, p <0.003). Fur thermore, increasing incidence of involuntary detrusor contractions wa s associated with increasing irritative symptoms, while increasing det rusor contraction duration was correlated with increasing obstructive symptoms. Detrusor contraction duration was correlated with symptom se verity and urodynamic outlet obstruction in men. Conclusions: These da ta demonstrated that the AUA symptom score correlates with certain uro dynamic parameters. Furthermore, this correlation occurs in men in con trast to women despite similar AUA symptom scores. In addition, increa sing detrusor contraction duration is associated with worsening sympto ms and may herald worsening obstruction. Further prospective studies a re underway to determine the prognostic value of these urodynamic para meters in altering ultimate outcomes of treatment.