Prospective Comparison of a New Visual Prostate Symptom Score Versus the International Prostate Symptom Score in Men With Lower Urinary Tract Symptoms

Objective To evaluate the correlation between the International Prostate Symptom Score (IPSS) and a new Visual Prostate Symptom Score (VPSS) using pictures rather than words to assess lower urinary tract symptoms (LUTS). Methods Four IPSS questions related to frequency, nocturia, weak stream, and quality of life (QoL) were represented by pictograms in the VPSS. Men with LUTS were given the IPSS and VPSS to complete. Peak (Qmax. ) and average (Qave. ) urinary flow rates were measured. Statistical analysis was performed using Student's t , Fisher's exact, and Spearman's correlation tests. Results The educational level of the 96 men (mean age 64, range 33–85 years) evaluated August 2009 to August 2010 was school grade 8–12 (62%), grade 1–7 (28%), university education (6%), and no schooling (4%). The IPSS was completed without assistance by 51 of 96 men (53%) and the VPSS by 79 of 96 men (82%) ( P < .001). Comparing education grade 10 groups, the IPSS required assistance in 27 of 31 men (87%) vs 9 of 38 men (24%) ( P < .001), and the VPSS required assistance in 10 of 31 men (32%) vs 3 of 38 men (8%) ( P = .014). There were statistically significant correlations between total VPSS, Qmax. and Qave. , total VPSS and IPSS, and individual VPSS parameters (frequency, nocturia, weak stream and QoL) vs their IPSS counterparts. Conclusions The VPSS correlates significantly with the IPSS, Qmax. and Qave. , and can be completed without assistance by a greater proportion of men with limited education, indicating that it may be more useful than the IPSS in patients who are illiterate or have limited education.