OBJECTIVE: The International Prostatic Symptom Score (IPSS) evaluates urinary disorder symptoms frequently associated with benign prostatic obstruction, but does not take into account the bothersomeness they induce. The Symptom Problem Index (SPI) evaluates the degree of discomfort associated with each question on the IPSS. Our objective was to explore the relationships between these two rating scales. METHODS: The IPSS and SPI self-administered scores were administrated to a cohort of 907 patients presenting with LUTS suggestive of BPO (Benign Prostatic Obstruction), for which 722 patients were evaluable. This diagnosis was made by GP (General Practitioner) in the 3-month period before their inclusion in the study. The correlation between SPI and IPSS was investigated and each symptom was classified according to its frequency and according to the bothersomeness it induced. The degree of bothersomeness associated with each IPSS symptom was evaluated and quantified based on quadratic function estimates. RESULTS: The mean IPSS score was 12.6+/-6.4, the mean SPI score was 12.2+/-6.5. The correlation coefficient between the IPSS and SPI scores was 0.70; the scores from the 2 rating scales showed a very high variability. On a 0-100% scale, where 100% represents a maximum bothersomeness, the induced bothersomeness ranged from 0 to 22.6% depending on the 7 symptoms. CONCLUSIONS: The two questionnaires do not collect the same information. The extent of variability between the two scales confirms that one scale cannot be replaced by the other. Considering the importance of bothersomeness associated with lower urinary tract symptoms for the therapy decision, the joint use of the IPSS and SPI seems appropriate.
OBJECTIVE: The International Prostatic Symptom Score (IPSS) evaluates urinary disorder symptoms frequently associated with benign prostatic obstruction, but does not take into account the bothersomeness they induce. The Symptom Problem Index (SPI) evaluates the degree of discomfort associated with each question on the IPSS. Our objective was to explore the relationships between these two rating scales. METHODS: The IPSS and SPI self-administered scores were administrated to a cohort of 907 patients presenting with LUTS suggestive of BPO (Benign Prostatic Obstruction), for which 722 patients were evaluable. This diagnosis was made by GP (General Practitioner) in the 3-month period before their inclusion in the study. The correlation between SPI and IPSS was investigated and each symptom was classified according to its frequency and according to the bothersomeness it induced. The degree of bothersomeness associated with each IPSS symptom was evaluated and quantified based on quadratic function estimates. RESULTS: The mean IPSS score was 12.6+/-6.4, the mean SPI score was 12.2+/-6.5. The correlation coefficient between the IPSS and SPI scores was 0.70; the scores from the 2 rating scales showed a very high variability. On a 0-100% scale, where 100% represents a maximum bothersomeness, the induced bothersomeness ranged from 0 to 22.6% depending on the 7 symptoms. CONCLUSIONS: The two questionnaires do not collect the same information. The extent of variability between the two scales confirms that one scale cannot be replaced by the other. Considering the importance of bothersomeness associated with lower urinary tract symptoms for the therapy decision, the joint use of the IPSS and SPI seems appropriate.