International Journal of Urology (2004) 11, 288–294 Blackwell Science, LtdOxford, UKIJUInternational Journal of Urology0919-81722004 Blackwell Publishing Asia Pty LtdMay 2004115288294Original Article Prostatic symptom scoring questionnaireM Yano et al. Correspondance: Kosaku Yasuda MD, Koshigaya Hospital, Dokkyo University School of Medicine, 2-1-50 Minami- Koshigaya, Koshigay-shi, Saitama 343–8555, Japan. Email: chiaki-n@dokkyomed.ac.jp Received 24 October 2002; accepted 10 November 2003. Original Article A pilot study evaluating a new questionnaire for prostatic symptom scoring, the SPSS, and its sensitivity as constructed to objective measures of outflow obstruction MASATAKA YANO, 1 SATOSHI KITAHARA, 1 KOSAKU YASUDA, 1 TOMONORI YAMANISHI, 1 HIDEO NAKAI, 1 RYOUZO YANAGISAWA, 2 MAKOTO MOROZUMI 3 AND YUKIO HOMMA 4 1 Department of Urology, Dokkyo University School of Medicine, Koshigaya Hospital, Koshigaya City, 2 Kasukabe Central General Hospital, 3 Koshigaya Municipal Hospital and 4 Faculty of Medicine, University of Tokyo, Japan Abstract Aim: To evaluate the extent to which our newly developed questionnaire, the Saitama Prostate Symptom Score (SPSS), for prostatic symptom scoring reflects objective findings in benign prostatic hyperplasia (clinical BPH) and to compare it with the International Prostate Symptom Score (IPSS) with regard to diagnostic sensitivity in clinical BPH. Methods: In this study, both the SPSS and the IPSS were self-administered by patients. Free uroflowmetry, a pressure-flow study and the measurement of prostatic volume were carried out. Results: There was no significant correlation between the results of the IPSS questionnaire and the urethral obstruction grade estimated by Schaefer or Abrams-Griffiths nomograms. The total score of the SPSS was correlated with these nomograms (P = 0.0487 and P = 0.0413, respectively). There was no significant correlation between the results of the IPSS questionnaire and the total volume or transition zone volume of the prostate, whereas the total score of the SPSS correlated with the total volume of the gland and transition zone volume (P = 0.0044 and P = 0.0051, respectively). Conclusion: This study revealed the SPSS to correlate with objective findings satisfactorily. How- ever, there are still several aspects of the SPSS which need to be improved upon, and the question- naire should be studied in larger numbers of patients suffering from lower urinary tract symptoms. Key words benign prostatic enlargement, benign prostatic hyperplasia, benign prostatic hyperplasia question- naire, benign prostatic obstruction, lower urinary tract symptoms. Introduction Clinical benign prostatic hyperplasia (clinical BPH) is a condition where the prostatic adenomatous tissue in the transition zone compresses the urethra (benign pro- static enlargement, BPE), resulting in an obstruction to the bladder outlet (benign prostatic obstruction, BPO), which causes various lower urinary tract symptoms (LUTS). Benign prostatic obstruction is found in 66– 75% of patients with clinical BPH, suggesting that BPO is not responsible for all of the symptoms of clinical BPH. 1 There must be multiple factors in the pathogen- esis of LUTS. At least five causative factors contributing to LUTS need to be considered: BPO, impaired detrusor contractility, detrusor overactivity, sensory urgency and BPE. 2–7 In order to quantify the severity of clinical BPH, several prostatic symptom scores have been devel- oped. 8–10 These include the American Urological Asso- ciation prostate symptom score, 11 which was renamed the International Prostatic Symptom Score (IPSS) and adopted as an international standard at the 1st Interna- tional Consultation on Benign Prostatic Hyperplasia (Paris, June, 1991). The IPSS has been found useful in