Editorial Comment to Evaluation and validation of the Core Lower Urinary Tract Symptom Score as an outcome assessment tool for the treatment of benign prostatic hyperplasia: Effects of the α1‐adrenoreceptor antagonist silodosin

Abstract

Ito et al. carried out a longitudinal symptom assessment of men receiving silodosin, an α1-adrenoreceptor antagonist, using the Core Lower Urinary Tract Symptom Score (CLSS), International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS) in a cohort of 241 patients with benign prostate hyperplasia (BPH) and BPH/overactive bladder (OAB).1 The results showed that the CLSS questionnaire is reflective of lower urinary tract symptoms (LUTS) in men with BPH and BPH/OAB, as well as IPSS and OABSS questionnaires. The correlation between baseline CLSS and the quality of life (QOL) index was relatively low in men with BPH (coefficient value = 0.314) and those with BPH/OAB (coefficient value = 0.244), thus the authors recommended that both the CLSS and QOL index should be used together. The 10 symptoms addressed in the CLSS questionnaire were selected from 25 symptoms defined by the International Continence Society Standardization Committee if more than one-quarter of patients with nine common conditions/diseases indicated the symptom as one of three most bothersome symptoms.2 Thus, the CLSS questionnaire is a non-disease-specific gender-free symptom assessment tool to capture important symptoms that might be overlooked by disease-specific questionnaires, such as IPSS or OABSS.2-5 In other words, the CLSS is not a disease-specific questionnaire and should have a low correlation with the QOL index in a cohort with definite diagnosis. The CLSS would be more useful for symptom assessment of subjects with multiple conditions or at the initial assessment and during a long-term follow up. For example, the prevalence of urgency incontinence or pain, which is addressed by the CLSS questionnaire alone, was low in this cohort. However these symptoms are relatively common in men with LUTS and have a definite impact on QOL.3, 5 None declared.