Comparison of the Danish prostatic symptom score with the International Prostatic Symptom Score, the Madsen‐Iversen and Boyarsky symptom indexes

Abstract

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.

Lower urinary tract symptoms and bladder control in advanced Parkinson's disease: Effects of deep brain stimulation in the subthalamic nucleus

“…3 In men with LUTS due to obstructed emptying, DanPSS is more responsive to treatment than the IPSS. 12,13 Our finding that urodynamic parameters did not change significantly after implantation of electrodes and after stimulation in the STN is in contrast to the findings of two other studies. 10,11 One study found that stimulation in the STN improved storage of urine, measured by both first desire to void and maximal bladder capacity, 11 whereas another study found stimulation in the STN only to affect the volume of first contraction in patients with overactive detrusor.…”

Prevalence of bladder dysfunction in Parkinsons disease

“…It is more sensitive than the IPSS questionnaire [Hansen et al, 1998], and we have previously used it in patients of both sexes with PD [Winge et al, 2004b[Winge et al, , 2005. The use of the integrated bother score in Dan-PSS may result in di¡erent conclusions compared to studies using only symptom scores.…”

Screening by lower urinary tract symptoms vs asymptomatic prostate‐specific antigen levels leading to radical prostatectomy in Danish men: tumour characteristics and treatment outcome

“…The incorporated outcome events including a patient-weighting of each symptom were shown to better reflect a patient's overall assessment of outcome [12]. In the present study information about whether symptoms or unsystematic PSA screening led to a cancer diagnosis formed the basis for dividing the population into symptomatic and asymptomatic groups.…”