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Grading severity and bother using the International Prostate Symptom Score and International Consultation on Incontinence Questionnaire Male Lower Urinary Tract Symptoms Score in men seeking lower urinary tract symptoms therapy

Ito, Hiroki; Young, Grace J.; Lewis, Amanda L.; Blair, Peter S.; Cotterill, Nikki; Lane, J. Athene; Sakamaki, Kentaro; Drake, Marcus J.; Abrams, Paul

Authors

Hiroki Ito

Grace J. Young

Amanda L. Lewis

Peter S. Blair

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N Nikki Cotterill Nikki.Cotterill@uwe.ac.uk
Professor of Long Term Conditions (Continence Care)

J. Athene Lane

Kentaro Sakamaki

Marcus J. Drake

Paul Abrams



Abstract

PURPOSE: We established severity banding ranges, bother assessment and key item content in principal patient reported outcomes measures in men seeking therapy for lower urinary tract symptoms. MATERIALS AND METHODS: Data for International Prostate Symptom Score (I-PSS) and International Consultation on Incontinence Questionnaire Male Lower Urinary Tract Symptoms (ICIQ-MLUTS) were derived from a study evaluating 820 men at 26 United Kingdom hospitals. ROC curves were used to establish severity bandings. RESULTS: Classification tree showed that thresholds between mild-moderate and moderate-severe severity bands were 15 and 27 for I-PSS, 16 and 26 for ICIQ-MLUTS/severity, and 22 and 81 for ICIQ-MLUTS/bother, respectively. Highest area under the ROC curve and lowest Akaike's information criteria of univariate logistic regression indicated that ICIQ-MLUTS/bother was more related to global quality of life than were I-PSS and ICIQ-MLUTS/severity. The symptoms affecting I-PSS-quality of life (QoL) were only fully identified by ICIQ-MLUTS, because 2 key symptoms (urinary incontinence and post-micturition dribble) are not measured by I-PSS. ICIQ-MLUTS demonstrated that bother of some lower urinary tract symptoms is disproportionate to severity, and that persisting high bother levels following surgery are more likely due to storage (18% to 25%) and post-voiding (18% to 28%) lower urinary tract symptoms than voiding lower urinary tract symptoms (5% to 13%). Symptom improvement after surgery was uncertain if baseline I-PSS-QoL score was less than 3. CONCLUSIONS: The severity threshold scores were measured for the 2 key lower urinary tract symptoms patient reported outcomes measures, and the results indicate suitable categories of symptom severity for use in men referred for urological care. The ICIQ-MLUTS measures all the lower urinary tract symptoms affecting quality of life and includes individual symptom bother scores.

Citation

Ito, H., Young, G. J., Lewis, A. L., Blair, P. S., Cotterill, N., Lane, J. A., …Abrams, P. (2020). Grading severity and bother using the International Prostate Symptom Score and International Consultation on Incontinence Questionnaire Male Lower Urinary Tract Symptoms Score in men seeking lower urinary tract symptoms therapy. Journal of Urology, The, 204(5), 1003-1011. https://doi.org/10.1097/JU.0000000000001149

Journal Article Type Article
Acceptance Date May 15, 2020
Online Publication Date May 29, 2020
Publication Date Nov 1, 2020
Deposit Date May 18, 2020
Publicly Available Date Mar 28, 2024
Journal Journal of Urology
Print ISSN 0022-5347
Electronic ISSN 1527-3792
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 204
Issue 5
Pages 1003-1011
DOI https://doi.org/10.1097/JU.0000000000001149
Keywords lower urinary tract symptoms; questionnaire; Urodynamics; IPSS; ICIQ-MLUTS
Public URL https://uwe-repository.worktribe.com/output/5985779
Publisher URL https://www.auajournals.org/toc/juro/0/0