A prospective correlational study of development and validation of a comprehensive visual prostate symptom score in men with lower urinary tract symptoms due to benign enlarged prostate

Purpose: C-VPSS was developed to address challenges faced by the IPSS in assessing LUTS in men which expands upon the original VPSS aiming for a more comprehensive and culturally accessible assessment tool. The objectives were to evaluate the C-VPSS in Indian patients with LUTS due to BEP, to assess its correlation with the IPSS overall scores and their individual components, and to examine the relationship of C-VPSS components with maximum urine flow on uroflowmetry and with patients’ educational status. Materials and methods: In a 6-month prospective correlational study at an Indian tertiary care hospital with ethics committee approval, we examined 92 adult patients over 50 years with LUTS due to benign prostatomegaly who had prior uroflowmetry, excluding certain medical conditions. Data from C-VPSS and IPSS questionnaires in regional language, educational status, and Uroflowmetry were recorded and analyzed using statistical tests with P < 0.05. Results: The mean age of 92 participants was 64.47 ± 7.6 years. Median IPSS and C-VPSS scores were 20 and 18. There was a positive correlation between the overall score (Spearman rho = 0.658, P < 0.01) and the respective components of C-VPSS and IPSS. Also, Bland-Altman’s analysis showed good agreement between the 2 scores (Bias −2.27, P < 0.01). A total of 65 patients (70.7%) reported that C-VPSS was easier to understand. Furthermore, 31 patients with limited formal education only up to the school level had a greater such correlation (r = 0.74 versus 0.57) and found C-VPSS to be easier ( P = 0.02). A negative correlation between C-VPSS and maximum urine flow (Qmax) in Uroflowmetry (r = −0.442 versus −0.326) was also noted. Conclusion: Our newer “Comprehensive”-VPSS correlates and agrees significantly better with IPSS. It was simpler and easier to respond to by Indian patients, especially those with limited formal education, and correlates with uroflowmetry better than IPSS.