Estimate Criteria for Diagnosis and Severity in Benign Prostatic Hyperplasia
Article first published online: 1 JUL 2007
International Journal of Urology
Volume 3, Issue 4, pages 261–266, July 1996
How to Cite
Hornma, Y., Kawabe, K., Tsukamoto, T., Yarnaguchi, O., Okada, K., Aso, Y., Watanabe, H., Okajima, E., Kumazawa, J., Yamaguchi, T. and Ohashi, Y. (1996), Estimate Criteria for Diagnosis and Severity in Benign Prostatic Hyperplasia. International Journal of Urology, 3: 261–266. doi: 10.1111/j.1442-2042.1996.tb00531.x
- Issue published online: 1 JUL 2007
- Article first published online: 1 JUL 2007
- Received Oct. 2, 1995; accepted for publication in revised form Jan. 19, 1996.
- Cited By
Background: Standard severity criteria for benign prostatic hyperplasia (BPH) are needed to facilitate clinical and epidemiologic investigations in the common terminology.
Patients and Methods: A total of 692 BPH patients from 8 institutions were judged by specialized physicians for their overall disease severity and severity in 4 domains: symptom, function, anatomy, and quality of life (QOL). The items measuring severity in these 4 domains were the International Prostate Symptom Score (I-PSS) questionnaire, uroflowmetry, transrectal ultrasonography (TRUS), and questionnaires on bother and I-PSS QOL index, respectively. By Spearman's rank correlation and multiple regression analysis using physicians' judgement as the criterion variable (gold standard) the items and their cut-off levels were selected so that high predictivity, practicality and clinical significance were maintained, while the number of items in use was minimized.
Results: The item(s) and their ranges of values for each severity grade were summarized as follows; the evaluation domain (the selected item(s): range of mild, moderate, severe): symptom (I-PSS: 0–7,8–19, 20–35), function (maximum flow rate and residual urine volume: ≥ 1 5 mL/s and < 50 mL, ≥ 5 mL/s and < 1 00 mL, < 5 mL/s or ≥ 100 mL), anatomy (prostate volume on TRUS: < 20 mL, < 50 mL, ≥ 50 mL), QOL (QOL index: 0 and 1, 2 to 4, 5 and 6). The overall severity was efficiently predicted when defined according to the combinations of severity grades of the 4 domains. These criteria predicted physicians' judgement with accuracy of about 80% for overall severity and severity of individual domains.
Conclusion: The proposed criteria are valid, practical, and would be useful for the common scale of the BPH severity in clinical and epidemiologic studies.