Symptom scores: mumbo jumbo or meaningful measures?

Instruments designed to assess the severity of lower urinary tract symptoms have become a routine component of the diagnostic evaluation of men with benign prostatic hyperplasia (BPH). Several validated tools have been developed to this end, including the International Prostate Symptom Score, which is used most commonly today. Despite attempts to correlate symptom score severity with commonly measured objective parameters of BPH, no clear relationships have been found. The reason for this is likely multifactorial and suggests a complex relationship among subjective and objective variables. However, symptom scores show a good correlation with the patient's perception of quality of life and degree of bother. This is critical because the decision to treat should be largely based on these subjective variables. Moreover, symptom scores have been shown to represent a meaningful endpoint in assessing treatment response in clinical studies.