The relationship of the international prostate symptom score and objectiveparameters for diagnosing bladder outlet obstruction. Part I: When statistics fail

Purpose: We evaluated the International Prostate Symptom Score and correlat ed it with objective means of determining bladder outlet obstruction. Materials and Methods: Beginning in May 1996, 460 men 41 to 88 years old (m ean age plus or minus standard deviation 60.4 +/- 9.4) were prospectively i ncluded in this study. Symptoms were evaluated using the International Pros tate Symptom Score, and digital rectal examination, outpatient cystoscopy, prostate specific antigen determination and transrectal ultrasound were don e. Urodynamic evaluation included uroflowmetry, filling cystometry and pres sure flow study. Results: Linear regression was done to correlate scores with measurable par ameters. We noted no correlation of the total, obstructive symptoms or irri tative symptoms score with objective parameters, including the average and maximum flow rate, post-void residual urine, prostate size and Schafer grad e. Conclusions: Prostatic symptom scores are qualitative. Using them to quanti fy the degree of obstruction or evaluate therapy is questionable.