Significant Correlation of the American Urological Association Symptom Score and a Novel Urodynamic Parameter: Detrusor Contraction Duration

Abstract

Purpose Various investigators have reported the lack of specificity of the American Urological Association (AUA) symptom score and its poor correlation with urodynamic parameters. A retrospective study was performed to ascertain the correlation of the AUA symptom score with various urodynamic parameters, including detrusor contraction duration. Materials and Methods The urodynamic records of 120 consecutive patients with moderate (scores 8 to 19) or severe (scores greater than 19) symptoms were retrospectively analyzed to ascertain if the AUA symptom score correlated with the urodynamic parameters of maximum detrusor pressure, detrusor pressure at maximum flow, compliance, involuntary detrusor contractions and, a novel parameter, detrusor contraction duration. Results There were 63 men (mean age 59.7 years) and 57 women (mean age 58.8 years). Men AUA symptom score plus or minus standard deviation was 17.8 plus/minus 3.7 and 15.4 plus/minus 2.9, respectively. There was no correlation between any urodynamic parameter and symptoms in women. In men increasing symptoms were associated with worsening urodynamic parameters. The 2 parameters that had the greatest correlation with symptom severity were incidence of involuntary detrusor contractions (r = 0.56, p less than 0.006) and detrusor contraction duration (r = 0.61, p less than 0.003). Furthermore, increasing incidence of involuntary detrusor contractions was associated with increasing irritative symptoms, while increasing detrusor contraction duration was correlated with increasing obstructive symptoms. Detrusor contraction duration was correlated with symptom severity and urodynamic outlet obstruction in men. Conclusions These data demonstrated that the AUA symptom score correlates with certain urodynamic parameters. Furthermore, this correlation occurs in men in contrast to women despite similar AUA symptom scores. In addition, increasing detrusor contraction duration is associated with worsening symptoms and may herald worsening obstruction. Further prospective studies are underway to determine the prognostic value of these urodynamic parameters in altering ultimate outcomes of treatment.