Lower Urinary Tract Symptoms in men are extremely difficult to interpretate, and assessing which is the principal factor that determines the deterioration in the quality of life of this population is one of the most challenging things. Several questionnaires are in used for assessing LUTS, being the most common the International Prostate Symptom Score (IPSS), at the same time male uroflowmetry is a non-invasive method usually performed in patients suspected of bladder outlet obstruction (BOO). In daily practice, it is common to use both IPSS and male uroflowmetry to study these patients. The aim of the study was to present the statistic correlation between the IPSS vs uroflowmetry parameters in a cohort of male LUTS patients versus a sub-analisis of the same cohort with a maximum flow rate (QMax) less than 10ml/seg.

Between January 2018 – January 2019, we performed a transversal analytical clinical study in a male cohort who were diagnosed with LUTS by clinical history. Informed consent was obtained, then IPSS questionnaire and male  uroflowmetry was obtained. Exclusion criteria were: needed assistance to complete the IPSS questionnaire for any reason, or a total uroflowmetry volume less than 150ml. Of the 153 patients willing to participate in the study, 134 fulfilled the criteria (n=134). The data that was obtained was later evaluated by bilateral Pearson’s Correlation Coefficient, to determine if our report has clinical significance. We performed bilateral correlation analysis of the global population of our study, and also performed the same correlation by severity of the value of IPSS (mild 0-7, moderate 8-19, severe 20-35). A fourth subanalysis of the data was made with the results of the population whose maximum flow rate (Qmax) was less than 10 ml/seg with the same statistic method.

The mean age of study population was 56 years (range 33-79). Mean value of IPPS was 17,5 (range 0-35 ). Patients for a further sub analysis were divided by the IPSS into mild symptoms n=65 (47,8%), moderate 45 (33,6%) and severe 25(18,7%). The mean maximum flow rate was 18,04(range 4-59 ), mean medium flow rate was   11,3 (range 1,7-37,5), and average flow rate 8,66 (range 1,2-29,9).  The Pearson´s correlation between the data obtained in the whole population was not statistically significant; the bilateral correlation obtained for Qmax (figure 1) , Q medium and Q average  vs IPSS was Rho - ,241, -,361 and -,369 respectively. The same statistic results were obtained were each subgroup of IPSS severity were correlated with Uroflowmetry parameters. But in the sub analysis, confronting only the population with a Qmax less than 10ml/seg, the bilateral correlation obtained for Q max, Q medium and Q average  vs IPSS was Rho -,527 (figure 2), -563, and -,535, that could be consider statistically moderated to strong correlation, for this sample. The total value of IPSS has a strong correlation with the value of the quality of life of the same IPSS:  ,740 and ,587 in both IPSS vs Qmax for the whole sample and the IPSS vs the Qmax less than 10ml/seg subanalysis.

In this study, our results based on our sample, show that, although IPSS is a non specific questionnaire for LUTS evaluation, and male uroflowmetry value has a strong dependency on voided volume and age (1), the correlation is strong between those two methods in male with Qmax les than 10 ml/seg when compared with non specific male LUTS population.

We do accept the limitations of our study, in terms of the size of the sample in the first place, which can alter statistics results, nevertheless there is a moderate to strong correlation between male with Qmax less than 10ml/seg and IPSS value and its QoL value as well. We do believed that correlation should be taken it into account in a  further research, to get better nomograms, that include the subjective interpretation of the patients about their clinical situation.

D’Ancona CD, Haylen BT, Oelke M, Herschorn S, Abranches-Monteiro L, Arnold EP, Goldman HB, Hamid R, Homma Y, Marcelissen T, Rademakers K, Schizas A, Singla A, Soto I, Tse V, de Wachter S. An International Continence Society (ICS) Report on the Terminology for Adult Male Lower Urinary Tract and Pelvic Floor Symptoms and Dysfunction. Neurourol Urodyn. 2019 DOI: 10.1002/nau.23897