Clinical value of international prostatic symptom score-voiding/storage subscore ratio in assessing lower urinary tract symptoms after transurethral electrovaporization prostatectomy

Abstract:

Objective：To investigate the clinical value of international prostatic symptom score-voiding/storage subscore ratio（IPSS-V/S） in assessing lower urinary tract symptoms（LUTS） after transurethral electrovaporization prostatectomy（TUVP）. Methods：A retro－spective analysis was performed for international prostatic symptom score（IPSS） and other clinical data of 234 patients with benign prostatic hyperplasia（BPH） who underwent TUVP from January 2015 to December 2016. According IPSS-V/S，these patients were divided into group A（80 patients with an IPSS-V/S≤1） and group B（154 patients with an IPSS-V/S>1）. IPSS，international prostatic symptom score-voiding（IPSS-V） score，international prostatic symptom score-storage（IPSS-S） score，and quality of life（QOL） score were reassessed at 6 months after surgery. Results：All 234 patients had significant reductions in IPSS and QOL score at 6 months after surgery（t=33.0 and 34.3，both P=0.000）. At 6 months after surgery，group B had a significantly greater improvement in IPSS than group A[（12.36±3.67） points vs. （8.20±3.21） points，t=8.96，P=0.000]. At 6 months after surgery，group A had a significantly higher IPSS-S score than group B[（9.61±2.88） points vs. （5.55±2.63） points，t=10.8，P=0.000]，while there was no significant difference in IPSS-V score between the two groups（t=1.56，P=0.120）. Although group A had a significant improvement in QOL score at 6 months after surgery[（3.59±0.91） points vs. （5.19±0.55） points，t=14.8，P=0.000]，group A had a significantly lower satisfaction rate than group B（13.75% vs. 70.78%）. At 6 months after surgery，group A had varying degrees of improvement in IPSS-S symptom scores，among which the score of urgency of urination showed the highest degree of improvement，followed by the scores of frequency of urination and nocturia；the score of nocturia had the lowest improvement rate of 36.3%（29/80），which was an important reason for the low degree of improvement in IPSS and QOL. Conclusion：Compared with IPSS，IPSS-V/S can reflect the outcome after TUVP more accurately，and voiding symptoms have sig－nificantly greater improvements than storage symptoms in LUTS. BPH/LUTS patients with nocturia as the main complaint have limited improvement in QOL after TUVP，which should be taken seriously by clinicians.