A prospective comparison of Visual Prostate Symptom Score versus International Prostate Symptom Score in Portuguese men

Abstract

Purpose: The International Prostate Symptom Score (IPSS) is an important tool in assessing lower urinary tract symptoms (LUTS) in men with benign prostate hyperplasia. However, due to its limitations, alternative scores emerged, such as the Visual Prostate Symptom Score (VPSS). This study aims to compare and correlate both questionnaires. Materials and methods: Between August and November 2017, 100 Portuguese patients suffering from benign prostate hyperplasia with LUTS were prospectively evaluated. Data collected included age, level of education, IPSS (Portuguese version), VPSS filling time and total scores, uroflowmetry measures, prostate-specific antigen value, and prostate volume. Statistical analysis comprised Spearman correlations and Wilcoxon tests. Results: The mean age of the participants was 68 years, and <30% of them had completed more than 4 years of schooling; 89% of the patients were able to complete the VPSS without help, but only 59% completed the IPSS alone. The Spearman correlation results showed a significant correlation between the total scores of IPSS and VPSS (ρ = 0.651, P < 0.001). Both the IPSS and the VPSS showed a negative correlation with maximum flow rate (Qmax) (ρ = −0.201, P = 0.046 and ρ = −0.228, P = 0.023, respectively). The median time spent filling the IPSS was significantly longer than that of the VPSS (median = 175, interquartile range =54 versus median = 93.5, interquartile range = 50; P < 0.001). Conclusion: VPSS demonstrated a significant correlation to IPSS and Qmax. It can be completed without assistance by a greater number of men and requires a shorter time to fill in than the IPSS. These findings suggest that VPSS can accurately assess the presence and severity of LUTS in a wider population than IPSS.