The correlation between bladder outlet obstruction and lower urinary tract symptoms as measured by the international prostate symptom score

Purpose: We studied the relationship between lower urinary tract symptoms as measured by the international prostate symptom score (I-PSS) and urodynamic findings in elderly men. Materials and Methods: We evaluated 803 consecutive patients with lower urinary tract symptoms via the I-PSS and urodynamics with pressure-flow studies. Results: A statistically significant correlation was found between all I-PSS questions (except intermittency) and objective parameters of obstruction. However, the clinical significance of this finding is minimal because a large overlap of symptom scores exists among patients with different grades of bladder outlet obstruction. The filling component of the I-PSS correlated somewhat better with obstruction than did the voiding component. Conclusions: It seems impossible to diagnose bladder outlet obstruction from symptoms alone. It does not even seem possible to define subgroups in which further urodynamic examination is indicated.