The International Prostate Symptom Score: Discrepancies between Self-administration and Physician-administration / 대한비뇨기과학회지

PURPOSE: The International Prostate Symptom Score (IPSS) is the most commonly used scoring system to quantify the lower urinary tract symptoms of benign prostate hyperplasia. The objective of this study was to measure any discrepancies in the Korean version of the IPSS when it is administered by the patients themselves as opposed to when it was administered by the physician. MATERIALS AND METHODS: Seventy two patients were asked to fill out two IPSS questionnaires during their first visit; one was self-administered and the other was administered by a physician in an interview. The total IPSS, quality of life and the individual questions were compared between the two modes of administration. RESULTS: Statistically significant differences were found in the mean total IPSS (16.9+/-8.44 versus 15.0+/-7.53, respectively) and the scores on questions 3 (intermittency) and 4 (urgency) between the self and physician administered IPSS (2.40+/-2.03 versus 1.47+/-1.88 and 1.86+/-1.87 versus 1.26+/-1.58, respectively). Thirty one patients (44.3%) demonstrated a difference of more than 3 points on the total IPSS score. CONCLUSIONS: This study suggests that there may be discrepancies between the self and physician administered IPSS scores. Therefore, physicians should review the score of each question, and especially those on intermittency and urgency.

The Role of Retrograde Urethrography as a Predictor of Early Recovery of Urinary Continence after Radical Retropubic Prostatectomy

PURPOSE: This study is designed to explore the role of retrograde urethrography as a predictor of recovery of urinary continence after radical retropubic prostatectomy. MATERIALS AND METHODS: A total of 40 patients who underwent radical retropubic prostatectomy from January 2005 to April 2007 were investigated. Among them one neurogenic bladder patient and one follow up loss patient were excluded. Voiding pattern and urinary incontinence were investigated with voiding diary monthly after Foley catheter removal. Recovery of urinary continence was defined as usage of less than 1 diaper per day. Pericatheter urethrography was conducted 2 weeks after operation. If definite bladder-urethral extravasation was not detected, an retrograde urethrography was performed immediately. 30 patients with sufficient length of urethra, regular margin of urethra and beaky appearance were defined as Group A, and 8 patients without above mentioned characteristics were marked as Group B. Differences between two groups were compared in terms of age, prostate volume, prostate specific antigen, urodynamic parameters, and duration of urinary incontinence. RESULTS: No significant differences were found in age, prostate volume, PSA between two groups. In group A, recovery rates of urinary continence were 70% (21 persons), 100% (30 persons) at 1,3 months after removal of catheter, respectively. In group B, rates of urinary continence recovery were 16.6% (1 person), 37.5% (3 persons), 75% (6 persons) at 1,3,4 months, respectively and 1 person regained continence at 7 months. CONCLUSION: A catheter free retrograde urethrography can be easily added after confirmation of bladder urethra anastomosis site healing. It gives us some valuable informations about external sphincter. The characteristics of retrograde urethrography can be used as a predictor of early recovery of postoperative incontinence.

The Efficacy of Transurethral Resection of Prostate on the Patients with Benign Prostatic Hyperplasia and Detrusor Hyperactivity with Impaired Contractility

PURPOSE: Detrusor hyperactivity with impaired contractility(DHIC) can be found in many elderly patients with benign prostatic hyperplasia(BPH). It is hard to expect the efficacy of transurethral resection of prostate(TURP) on such patients. Therefore, we retrospectively estimated the effect of TURP on BPH patients with DHIC. MATERIALS AND METHODS: Eighteen male patients with BPH and DHIC were underwent TURP. Through urodynamic studies, DHIC was identified. Findings of bladder outlet obstruction were evaluated with TRUS and/or diagnostic cystoscopy in all patients. They were requested to go through uroflowmetry and international prostate symptom score(IPSS), before and after TURP. The subjective satisfaction scale was measured after TURP. RESULTS: Total IPSS(from 20.6 to 12.5), obstructive symptom score(from 11.5 to 6.0), and maximal flow rate (from 6.0 ml/sec to 14.6 ml/sec) of the patients were improved significantly(p0.05). Only 2(12%) of the patients were unsatisfied with the outcomes of TURP. CONCLUSION: We suggest that TURP can be used as a good therapeutic option for selected patients with BPH accompanied with DHIC.