CORRELATION OF THE AUA SYMPTOM INDEX WITH URODYNAMICS IN PATIENTS WITH SUSPECTED BENIGN PROSTATIC HYPERPLASIA

The AUA symptom index is widely used to access patients with suspected benign prostatic hyperplasia (BPH). In order to determine how well sy mptoms as assessed by this index correlate with urodynamic findings, w e evaluated 83 patients referred to our urology clinics with symptoms of BPH. All patients completed the AUA symptom index and then underwen t a multichannel urodynamic evaluation. Patients were classified as ob structed, unobstructed, or equivocal according to the Abrams Griffiths nomogram. The AUA symptom index was recorded as the total score and, for purposes of symptom classification, further subdivided into an obs tructive score (questions 3, 5, and 6) and an irritative score (questi ons 1, 2, 4, and 7). The mean age of the 83 patients was 67 (45-84). T he mean total AUA symptom score was 16.6 (6-34), mean obstructive scor e was 6.1 (0-15), and the mean irritative score 10.4 (3-20). Pressure flow analysis using the Abrams-Griffiths nomogram classified 28 patien ts (34%) as obstructed, 17 (20%) as unobstructed, and 38 (46%) as equi vocal. Using the analysis of variance procedure (ANOVA) there was no s tatistically significant difference in the mean total (P = 0.446), obs tructive (P = 0.979), or irritative (P = 0.136) scores. Detrusor insta bility was present in 45 patients (54%). While total and obstructive s cores were not significantly different in patients with detrusor insta bility vs. those with stable bladders, irritative scores were higher i n patients with instability (P = 0.028) using the T-test procedure. Us ing ANOVA, the difference in post void residual (PVR) between the grou ps was not quite statistically significant (P = 0.057). The AUA sympto m score does not appear to correlate with urodynamic obstruction. Howe ver, higher irritative symptom scores are associated with detrusor ins tability. It is likely that in many men with ''BPH,'' symptoms are not caused by outlet obstruction and may be related to changes in the agi ng bladder. (C) 1994 Wiley-Liss, Inc.