Prostate Disease Severity Score: In the management of benign enlargement of prostate

Abstract

Objective: Developing a simple, user-friendly objective severity scoring system for symptomatic benign enlargement of prostate (BEP) and comparing with International Prostate Symptom Score (IPSS). Subjects and Methods: In this prospective study, patients with BEP completed IPSS proforma. A grading system was developed for peak flow of urine ( Qmax), transitional zone index (TZI), detrusor wall thickness (DWT) and intravesical prostatic protrusion (IPP). Prostate Disease Severity Score (PDSS) was developed as sum of the variables. Results: Among 115 patients, obstructive voiding (70.43%) was predominant symptom followed by storage symptom (10.44%). Among predominant obstructive voiders, grades 1–3 TZI was common (97.53%), followed by IPP (64.19%) and DWT (62.96%) of varying grade. IPP, DWT, TZI and Qmax proved to be strong determinants of obstructive voiding ( p < 0.05). The components of PDSS correlated well with total score ( p < 0.05), positively correlated with IPP, DWT and TZI, and negatively with Qmax ( p < 0.05); correlation with IPSS was statistically significant ( p < 0.05). According to PDSS, 92.5% (37/40) patients with severe, 73.02% (46/63) with moderate, 8.33% (1/12) with mild degree of obstruction needed surgical intervention. Conclusion: The objective nature, comparable correlation with IPSS, potentiality to predict future need for surgical intervention, makes PDSS, a potential user-friendly assessment tool in management of BEP. Level of evidence: Not applicable