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Objective  To compare the Danish Prostatic Symptom Score (DAN‐PSS) with the International Prostatic Symptom Score (IPSS), Madsen‐Iversen and Boyarsky symptom indexes in a clinical setting, and to evaluate the potential significance of any differences in information obtained from these questionnaires. Patients and methods  The study comprised two substudies: in the first, 205 patients with lower urinary tract symptoms (LUTS) suggestive of bladder outlet obstruction (BOO), a Madsen‐Iversen score >6 and a maximum flow rate of <10 mL/s were randomized to receive either placebo or alfuzosin in a double‐blind study of 16 weeks. The symptoms were assessed using the Madsen‐Iversen, DAN‐PSS and the IPSS questionnaires. In the second, 138 patients with LUTS suggestive of BOO were selected for treatment with transurethral microwave thermotherapy (TUMT, 52°C for 60 min, microwave energy 200 kJ) and their symptoms assessed using the Boyarsky and the DAN‐PSS questionnaires. Patients were then followed for one year. Rank correlation coefficients and regression lines were calculated using Spearman’s non‐parametric test. The relative changes, i.e. responsiveness, calculated for the DAN‐PSS, IPSS and Boyarsky indexes were compared pairwise using the Wilcoxon‐Pratt test. Results  The DAN‐PSS, IPSS and Madsen‐Iversen indexes were correlated on a pairwise basis. The DAN‐PSS and IPSS indexes have significant construct validity in terms of correlation with the Madsen‐Iversen system (Spearman’s correlation coefficient, rs=0.51 and rs=0.45, respectively). The DAN‐PSS and the IPSS indexes were correlated (rs=0.61). The DAN‐PSS was more sensitive than the IPSS to changes after pharmacological treatment, with scores decreasing 70% and 29% (P<0.05), respectively, after treatment with an alpha‐blocker for 4 months, and 50% and 29% (P<0.05), respectively, after 4 months on placebo treatment. Finally, the responsiveness of the Boyarsky and DAN‐PSS indexes to TUMT showed that the DAN‐PSS system was significantly more responsive than the Boyarsky index, with scores decreasing 57% and 15% (P<0.05), respectively, after one year. Conclusions  The DAN‐PSS index is more sensitive than the IPSS, Madsen‐Iversen and Boyarsky symptom indexes, incorporates important outcome events, includes a patient‐weighting of each symptom, thereby reflecting better the patients’ global assessment of outcome.

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The treatment and prognosis of bladder cancer are based on the depth of primary tumour invasion and the presence of metastases. A highly accurate preoperative tumour, node, metastasis (TNM) staging is critical to proper patient management and treatment. This study retrospectively investigated the value of ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/computed axial tomography (¹⁸F-FDG PET/CT) and magnetic resonance imaging (MRI) for preoperative N staging of bladder cancer. Material and methods. From June 2006 to January 2008, 48 consecutive patients diagnosed with bladder cancer were referred to preoperative staging including MRI and ¹⁸F-FDG PET/CT. Eighteen out of 48 patients underwent radical cystoprostatectomy including removal of lymph nodes for histology, and were included in the study. Values of ¹⁸F-FDG PET/CT and MRI for regional N staging were compared to histopathology findings, the gold standard. Results. ¹⁸F-FDG PET/CT and MRI were performed in 18 patients. The specificities for detection of lymph-node metastases for MRI and ¹⁸F-FDG PET/CT were 80% (n = 15) and 93.33% (n = 15), respectively. The negative predictive values were 80% (n = 15) and 87.5% (n = 16) for MRI and ¹⁸F-FDG PET/CT, respectively. The differences in specificity and negative predictive values were not statistically significant. Conclusions. No significant statistical difference between ¹⁸F-FDG PET/CT and MRI for preoperative N staging of urothelial bladder cancer was found in the study. However, the trend of the data indicates an advantage of ¹⁸F-FDG PET/CT over MRI. Larger prospective studies are needed to elucidate the role of ¹⁸F-FDG PET/CT in N staging of bladder cancer.