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International Prostate Symptom Score questionnaire. 

International Prostate Symptom Score questionnaire. 

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Background: Lower urinary tract symptoms (LUTSs) due to benign prostatic hyperplasia (BPH) are common conditions in middle-age or older men. The International Prostate Symptom Score (IPSS) is a useful and validated questionnaire to evaluate LUTS secondary to BPH. Van der Walt et al have developed an alternative questionnaire named the Visual Prosta...

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... this study, we attempted to evaluate the relationship between the VPSS (Fig. 1) and IPSS (Fig. 2) in Indian population. The IPSS questionnaire has seven questions, which are used to evaluate storage and voiding symptoms in patients with BPH. The patient is given five options for the first seven questions and each option indicates severity of that symptom. The total score ranges from 0 to 35 and LUTSs are classified as mild to ...

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... The level of education appears to be related to the level of completion of a self-administered IPSS. The lower the patients' level of education, the smaller the chance that they are able to complete the IPSS unaided [10][11][12]. A similar relationship was found between the level of education and correctness of symptom representation when completing the IPSS [13,14]. ...
... Correlations between IPSS scores and VPSS and uroflowmetry parameters in earlier studies. All correlations presented are nonparametric Spearman's rank order correlations, except for the parametric Pearson's product-moment correlations presented in Bhomi (2017) [43], Memon (2016) [44] and Taneja (2017) [12]. ...
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Lower urinary tract symptoms are common complaints in ageing people. For a urological evaluation of such complaints in men, the International Prostate Symptom Score (IPSS) is used worldwide. Previous quantitative studies have revealed serious problems in completing this questionnaire. In order to gain insight into the nature and causes of these problems, we conducted a qualitative study. Not only the purely verbal IPSS was studied but also two alternatives, including pictograms: the Visual Prostate Symptom Score (VPSS) and the Score Visuel Prostatique en Image (SVPI). Men aged 40 years and over with an inadequate level of health literacy (IHL; n = 18) or an adequate level of health literacy (AHL; n = 47) participated. Each participant filled out one of the three questionnaires while thinking aloud. The analysis of their utterances revealed problems in both health literacy groups with form-filling tasks and subtasks for all three questionnaires. Most noticeable were the problems with the IPSS; the terminology and layout of this form led to difficulties. In the VPSS and SVPI, the pictograms sometimes raised problems. As in previous research on form-filling behavior, an overestimation by form designers of form fillers’ knowledge and skills seems to be an important explanation for the problems observed.
... They found that age and level of education were more influential in treatment decisions, rather than personality factors. Another survey used discrete choice experiments Randomized controlled trials Ham et al. [12] No difference in patient understanding but higher satisfaction in multimedia rather than standard written informed consent Prospective Studies Wallner et al. [2] Most men do not seek care for BPH or LUTS and should specifically be targeted Taneja et al. [13] A visual prostate symptom score could be completed by more patients without help Kajimotu and Bowa [14] A single-question nocturia score correlates with the standard IPSS Van der Wijden et al. [15] A decision aid improves the decision quality and should be implemented in routine care Cross-sectional studies Foster et al. [7] Older men with higher education and rates of engagement with medical system are more likely to report BPH diagnosis Ertel et al. [11] Asian and Latin American men also have areas of discordance between patient and physician perceptions of BPH Retrospective Studies Kesari et al. [16] Age and education are more likely to influence treatment decisions rather than personality Li et al [17] Personalized education rather than uniform education and informed consent before surgery reduces perioperative anxiety Descriptive Studies Clarke et al. [18] Patient preference should be included in quality metrics Tanwar et al. [19] Negative correlation between quality of publicly available videos about BPH and search result ranking Mankowski et al. [20] Treatment decision may be optimized by understanding what benefits and side effects are of greatest concern Lamers et al. [21] Patients should be involved in development of decision aids Koo and Yap [22] Most online information about BPH is at a reading level too advanced for most adults Moses et al. [23] The AUA symptom score is frequently not completed or takes longer to complete for men with low health literacy Ojewola et al. [10] There is poor level of knowledge and screening for BPH in Nigeria Kosilov et al. [9] Positive correlation between level of education and health-related quality of life among men with BPH Huang et al. [24] Online information about prostate embolization is of low to moderate quality Sare et al. [25] Online information about BPH is writted at a level too difficult for the average adult Lee et al. [8] Numerous unmet needs exist in patients with BPH across age and level education Betschart et al. [26] Most videos on the surgical treatment of BPH are low-quality and provide misinformation Gaines and Malik [27] The majority of questionaires about BPH are too advanced for most adults Selman et al. [28] Men with LUTS report and prefer different kinds of decision-making support from clinicians to determine the most important factors for men in choosing pharmacologic therapy. Authors found that a medication must provide improvement in more than one symptom to compensate for side effects [20]. ...
... Other studies found that the American Urologic Association (AUA) symptom score is frequently not completed or takes longer to complete for men with low health literacy, and that other questionnaires have similar shortcomings [23,27]. Potential solutions include a visual prostate symptom score or a single-question score assessing nocturia, both of which have been found to correlate with the standard IPSS [13,14]. ...
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Purpose of Review Benign prostatic hyperplasia (BPH) is an ideal disease model to consider the utility and impact of patient engagement since treatment choices, outcomes, and side effects are complex. The aim of this review is to evaluate existing research from 2015–2021 to identify established ways patient engagement has been applied to BPH as well as areas for improvement. Recent Findings Several studies describe the development and implementation of decision aids and new forms of informed consent to better facilitate patient engagement and decision-making. It has also been demonstrated that existing publicly available information about BPH is either difficult for patients to understand or is inaccurate. Summary There are many medical and surgical options available for BPH management. Increased patient engagement, through patient education, decision aids, and shared decision-making, can address some of the unmet needs in BPH care.
... VPSS was also validated by the same authors for urethral stenosis (n = 100) [16]. The VPSS was used in several works in a hospital setting: Namibia in 2014, n = 100 [17], Indonesia in 2014, n = 103 and 2019, n = 191 [18,19], Turkey in 2014, n = 191 [8], Korea in 2014, n = 240 [20], USA in 2015, n = 129 [21], India in 2016, n = 100 and 2017, n = 121 [22,23] and Thailand in 2017, n = 200 [24]. Significant correlations with the IPSS and several urodynamic parameters, such as Qmax and Qave, as well as higher rates of response without assistance Content courtesy of Springer Nature, terms of use apply. ...
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Purpose Validate a visual scale to assess LUTS, especially in developing countries, as an alternative to IPSS. VASUS consist of five questions, where Q1 and Q2 assess urinary stream quality, Q3 nocturia, Q4 incomplete emptying and Q5 QoL. Methods Between 2014 and 2017, we carried out a study in the male population over 30 years from São Tomé and Príncipe, a Portuguese speaking African Country. A stratified sample (age and district) of subjects completed IPSS, VASUS and a free flowmetry. Results We obtained 812 valid responses (average age: 50.72, range: 30–95 years old). In the comparison between IPSS and VASUS, we found positive correlations, with p value < 0.0001, for all variables analyzed and negative correlation for all urodynamic variables. Upon verifying the association of VASUS with IPSS, namely when comparing questions with similar objectives such as nocturia (VASUS—Q3 and IPSS—Q7), the stream quality (VASUS—Q1 and Q2 and IPSS—Q5) or the quality of life (VASUS—Q5 and IPSS—Q8), strong positive correlations were found. Conclusion VASUS is a visual alternative to IPSS allowing evaluation of LUTS and having correlation with IPSS and flowmetry. Its use in developing countries with low levels of literacy will be an asset. The authors believe that widespread use of a scale such as VASUS in urology consultations is warranted, to increase daily practice objectification of LUTS.
... Estos resultados son similares a los informados por Van der Walt et al.,(7) que mostraron que la mayoría de pacientes, en especial los pacientes sin estudios superiores, necesitaban menos ayuda para cumplimentar el cuestionario visual. Además, observamos que el tiempo de respuesta es significativamente menor para responder el VPSS que el IPSS, resultados que concuerdan con el trabajo de Yogesh Taneja et al.,(15) en el que se publicaron datos similares.El presente estudio supone, en estos momentos, una de las primeras comparaciones de ambos cuestionarios en nuestro medio, aportando datos adicionales tanto a nivel diagnóstico como a nivel de estratificación de los pacientes por nivel de estudios respecto a los trabajos publicados hasta el momento. ...
Article
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Introducción: Los síntomas del tracto urinario inferior (STUI) son uno de los principales motivos de consulta en urología. El International Prostate Symptom Score (IPSS) es una herramienta útil en la valoración de los STUI pero en la práctica clínica diaria no siempre resulta fácil para todos los pacientes su cumplimentación. Objetivo: Comprobar si existe una correlación adecuada entre el Visual Prostate Symptom Score (VPSS) y el IPSS en el estudio de los pacientes con STUI y evaluar las diferencias en cuanto a la necesidad de ayuda y el tiempo requerido para su autocumplimentación. Material y métodos: Se realizó un estudio prospectivo, multicéntrico, desde junio de 2019 a enero de 2020. Se entregaron ambos cuestionarios a los pacientes para su autocumplimentación en la consulta de Urología. Posteriormente, en la misma consulta se realizó una flujometría y una ecografía prostática. Se analizaron las variables: edad, puntuación del IPSS, puntuación del VPSS, necesidad de ayuda para cumplimentar los cuestionarios, tiempo empleado, flujo máximo (Qmáx), volumen prostático y nivel de estudios. Para el análisis estadístico se utilizó el coeficiente de correlación de Spearman. Resultados: Se recogieron un total de 101 pacientes con STUI. La media de edad fue de 68’53 años. El flujo máximo fue de 9.2 ml/s de media y el volumen prostático de 50’77 cc de media. El nivel de estudios fue: estudios primarios en el 49’5% de pacientes, secundarios el 20’8%, formación profesional el 13’8% y universitarios el 7’9%. Se observó una correlación negativa entre la puntuación total del IPSS y el VPPS con el Qmáx. El tiempo requerido y la necesidad de ayuda fueron mayores para la cumplimentación del IPPS que para el VPSS, siendo estas diferencias estadísticamente significativas. Los pacientes con estudios primarios precisaron menor tiempo y ayuda para completar el VPPS. Conclusiones: El VPSS se correlaciona con el IPSS, con la ventaja de ser más fácil y rápido de completar por los pacientes.
... 7,8 The IPSS questionnaire includes a total of 8 questions: 7 symptom questions (0-5 points) and 1 quality of life question (QoL, 0-6 points). The total score is divided into 3 classes to determine the severity of LUTS; mildly symptomatic (0-7), moderately symptomatic (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19), and severely symptomatic (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). Although the IPSS questionnaire is successful in the evaluation of LUTS, some factors can limit its use in clinical practice. ...
... Previous studies have shown difficulties in completing IPSS in regions with low educational levels and large populations. Netto et al 17 [12][13][14][15][19][20][21][22][23][24][25][26][27][28] Most of these studies have shown VPSS has a significant positive correlation with IPSS (Suppl. Table 1). ...
Article
Objective: To evaluate the correlation between Visual Prostate Symptom Score (VPSS) and the International Prostate Symptom Score (IPSS) and uroflowmetry parameters in men with lower urinary tract symptoms (LUTS) with literature review. Methods: Patients were pooled from 4 different urology clinics in Turkey and divided into 3 groups according to their educational level. The scores of IPSS and the VPSS questionnaire, assistance requirement and completion time of the questionnaires were recorded. Maximum flow rate (Qmax) and average flow rate (Qave) were determined with uroflowmetry test and the results are recorded. Results: A total of 342 patients were evaluated (group 1, n= 168; group 2, n= 108; group 3, n=66). Median age of all groups was 61 (40-89). There was a significantly higher rate of the completion of VPSS than IPSS without assistance in total (p <0.001. Educational level was not found as an independent factor with assistance requirement to complete VPSS while university educational level was found as an independent factor to complete IPSS (OR=9.735, p<0.001).There was a significantly lower completion time for VPSS in all groups when compared to IPSS (p<0.001 for all groups). Significant positive correlations were found between VPSS and IPSS questions (p <0.001). There were significant negative correlations between total score and weak stream question of VPSS and Qmax and Qave, separately (p <0.001). Conclusion: VPSS can be more practical than IPSS to evaluate LUTS in men with low educational levels and/or in large populations. Some modifications are needed to increase the availability of VPSS.
... Because this study included data from a single institution, a potential selection bias may have occurred. Nevertheless, our study results are valuable because limited data are available from rural Indian 32 populations to elucidate an association between the VPSS and IPSS. Clarity of images and requirement of additional images (urgency) has been stated as a minor drawback and we too agree with these 33 suggestions based on our clinical experience. ...
Article
Introduction: The international prostate symptom score (IPSS) is widely used to assess the severity of lower urinary tract symptoms (LUTS), but is very complicated & difficult to comprehend. Visual Prostate Symptom Score (VPSS) was introduced to overcome the drawbacks of the International Prostate Symptom Score (IPSS). Materials & Methods: This was a prospectively designed study conducted at Regional Institute of Medical Sciences, Imphal. A total of 200 patients who presented to the urology outpatient department with LUTS due to BPH were enrolled in the study. All patients were given both questionnaires. The correlation test was used to assess the correlation between two symptom scores and various parameters. Observations with a P value < 0.05 were considered statistically significant. Results: Of 200 patients, 61% of them were above the age of 60 years; mean ± standard deviation age was 62.72 ± 9.11 (range 48– 84 years). Total time taken to complete IPSS & VPSS were 589.30 ± 190.74 sec & 175.35± 62.59 sec respectively. There was a statistically significant difference in the number of patients requiring assistance to fill the questionnaires according to their education level. There was a positive correlation between IPSS total score and VPSS total score (r = 0.54; P < 0.001), IPSS Qol versus VPSS Qol (r = 0.53; P < 0.001). A negative correlation was observed between total VPSS and Qmax (r= -0.719; P < 0.001), total IPSS and Qmax (r= -0.654; P < 0.001). All VPSS questions showed statistically significant correlation with the corresponding IPSS questions. Conclusion: VPSS can be used as a better alternative to IPSS which is easier, more compliant, takes lesser time and even can be understood by a less educated person.
... [17,18] Ability to complete the chart without assistance is most helpful for patients with limited education and in places with limited resources. [19] VPSS has been used in the Indian population, [20] and found to be useful for the people residing in rural areas, and illiterates, or those with lesser education. [21] Also, there is a suggestion that VPSS can replace IPSS to evaluate LUTS in elderly men. ...
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Introduction: Visual Prostate Symptom Score (VPSS) was introduced to overcome the drawbacks of the International Prostate Symptom Score (IPSS). However, this score also has potential for improvement. Materials and Methods: The primary objective of this study was to evaluate the utility of VPSS in patients with benign enlarged prostate (BEP) after uroflowmetric validation of the stream component. The secondary objective was to improve VPSS by adding a new severity grading and to assess if the "new upgraded VPSS" can replace IPSS in terms of ease of completion without assistance and the time taken. Results: Of 115 patients, 42.60% of them were of thea age group between 61– 70 years; mean ± standard deviation age was 64.75 years ± 8.042 (range 48– 90 years). Nineteen (16.52%) patients, who had education level ≥10th grade completed IPSS without assistance.. One hundred and eight (93.91%) patients completed VPSS without assistance (P = 0.000). None of those (0/6) with no formal education (but able to read and write) could complete the IPSS without assistance, whereas 66.67% completed the VPSS without assistance. Six minutes and two minutes was the average time taken to complete IPSS (4– 10 min) and VPSS (1– 3 min), respectively. Responses to different variables of VPSS were statistically significant (P < 0.001) compared to the IPSS. Correlation between the severity grading of the two scores was statistically significant (P < 0.001), with a statistically significant positive correlation between VPSS and IPSS (r = +0.582, P < 0.001). The new severity grading system developed on par with the IPSS, improvising the existing VPSS, showed statistically significant positive correlation to the IPSS (r = +0.587, P < 0.001). Conclusions : VPSS correlated well with IPSS. The "new improvised VPSS" developed by incorporating severity grading is a potential tool that can replace IPSS by overcoming its limitations.
... Discussion: Benign prostate hyperplasia associated LUTS is very common problem in middle age or older men [6]. The IPSS is a useful questionnaire for evaluating the severity of LUTS and treatment efficacy of BPH in follow up [7]. ...
... The symptom score ≤7, 8-19, ≥20 are classifed as mild, moderate and severe symptoms. But, most patients with a low education level can not answer the IPSS questionnaire correctly, eyesight related and cognitive problems are negative factors after the age of 50 years [6]. The patients usually ask questions the health workers for the explanation of the question because of its complexity [3]. ...
... completed VPSS but only 48 patients(43.63%) could completed the IPSS [6]. The education level of the patients; 54.5% was <Grade 9 and 45.5% was >Grade 9. ...
... Discussion: Benign prostate hyperplasia associated LUTS is very common problem in middle age or older men [6]. The IPSS is a useful questionnaire for evaluating the severity of LUTS and treatment efficacy of BPH in follow up [7]. ...
... The symptom score ≤7, 8-19, ≥20 are classifed as mild, moderate and severe symptoms. But, most patients with a low education level can not answer the IPSS questionnaire correctly, eyesight related and cognitive problems are negative factors after the age of 50 years [6]. The patients usually ask questions the health workers for the explanation of the question because of its complexity [3]. ...
... completed VPSS but only 48 patients(43.63%) could completed the IPSS [6]. The education level of the patients; 54.5% was <Grade 9 and 45.5% was >Grade 9. ...
Article
Introduction: Benign prostate hyperplasia is one of the most common disease in elderly men. The patients usually present lower urinary tract symptoms including frequency, urgency, nocturia and interittancy. The prostate symptom scores are usually used for daily urology practice. We aimed to compare the International Prostate Symptom Score and Visual Prostate Symptom Score in Turkish patients. Method: s. The study protocol was conducted from from February to August 2017. The patients presenting with lower urinary tract symptoms over the age of 45 years were included. The age, prostate specific antigen level, education level and symtom scores were recorded. The patients with history of neurological disease, prostatic surgery, radiotherapy and any malignancy were excluded. Results: There were 81 patients in the current study. The mean age and PSA level was 58.86+/-7.39 years and 1,94+/-1,77 ng/ml. Most of the patients (54.32%) had primary level of education and the patients who were graduated from university (19.75%) followed. The secondary and high school level was 12.34% and 13.58% respectively. The fully complete rate of the symptom scores 37% for IPSS and 9.8% for VPSS and 81% for CSS (p<0.05). In the patients with fully complete; there was no significant difference for patients education level and age. Conclusions: The IPSS and VPSS are established symtom scores for patients with benign prostate hyperplasia. The difficulties to understand and translate problems of these questionnaires; new, mother language originated symptom score is needed for Turkish patients.
... 16 Similarly, a recent study in India by Taneja et al showed that the VPSS could be completed by most people with low level of education. 17 An earlier study in Namibia showed that apart from illiteracy, language was not a barrier in completing the VPSS questionnaire. 18 Dr. ...
... The results of our study were similar and consistent with the results of previous studies (Table 5). 8,9,12,17,20 In addition, similar to earlier studies, uroflowmetry parameter Qmax (maximum urinary flow rate) was significantly correlated with the IPSS question 5 and its VPSS counterpart (question 3). This showed that similar to the IPSS, the VPSS may be used to evaluate the urinary stream. ...
... This showed that similar to the IPSS, the VPSS may be used to evaluate the urinary stream. 8,9,17,21 Wessels et al had used the VPSS in assessing LUTS in patients with urethral stricture disease. The study found that the VPSS correlated significantly with the IPSS, Qmax, and urethral diameter. ...
Article
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Background: The complexity of International Prostate Symptom Score (IPSS) as an objective questionnaire for lower urinary tract symptoms might be overcome with alternative questionnaire such as the Visual Prostate Symptom Score (VPSS) which uses pictograms instead of questions to illustrate some of the questions addressed in IPSS. Methods: Male patients older than 45 years with lower urinary tract symptoms were evaluated with Indonesian version of the IPSS and VPSS, for uroflowmetry parameters using a transabdominal ultrasound. Appropriate statistical analysis was used. Results: Of all participants, 24.2% and 11.1% require assistance when answering IPSS and VPSS questionnaires, respectively. The mean age, IPSS total score, VPSS total score, Qmax, voided volume, and postvoid residual volume were 67.4 ± 8.9 years, 13.4 ± 7.8, 10.8 ± 2.7, 13.6 ± 8.6 mL/sec, 248 ± 136 mL, and 54.9 ± 68.3 mL, respectively. Total IPSS, IPSS quality of life (QoL), IPSS question (Q) 2, IPSS Q7, and IPSS Q5 were significantly correlated with total VPSS, VPSS QoL, VPSS Q1, VPSS Q2, and VPSS Q3 [correlation coefficient (r) P value: 0.57, <0.001; 0.76, <0.001; 0.39, <0.001; 0.72, <0.001; 0.50, <0.001, respectively]. VPSS Q3 was significantly correlated with Qmax (r, P value: -0.26, <0.001). There was a significant relationship between the level of education and the ability to complete IPSS questionnaire (P < 0.001). There was no significant relationship between the level of education and the ability to complete VPSS questionnaire (P = 0.649). Conclusion: The VPSS was significantly correlated with IPSS and Qmax. The novel questionnaire proved useful as an alternative tool for IPSS for assessing men with lower urinary tract symptoms, especially for those with lower level of education.