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Urinary Symptom Score



The International Prostate Symptom Score (I-PSS) is based on the answers to seven questions
concerning urinary symptoms and one question concerning quality of life. Each question
concerning urinary symptoms allows the patient to choose one out of six answers indicating
increasing severity of the particular symptom. The answers are assigned points from 0 to 5. The
total score can therefore range from 0 to 35 (asymptomatic to very symptomatic).
The questions refer to the following urinary symptoms:
Questions Symptom
1 Incomplete emptying
2 Frequency
3 Intermittency
4 Urgency
5 Weak Stream
6 Straining
7 Nocturia
Question eight refers to the patient’s perceived quality of life.
The first seven questions of the I-PSS are identical to the questions appearing on the American
Urological Association (AUA) Symptom Index which currently categorizes symptoms as
follows:
Mild (symptom score less than of equal to 7)
Moderate (symptom score range 8-19)
Severe (symptom score range 20-35)
The International Scientific Committee (SCI), under the patronage of the World Health
Organization (WHO) and the International Union Against Cancer (UICC), recommends the use
of only a single question to assess the quality of life. The answers to this question range from
“delighted” to “terrible” or 0 to 6. Although this single question may or may not capture the
global impact of benign prostatic hyperplasia (BPH) Symptoms or quality of life, it may serve as
a valuable starting point for a doctor-patient conversation.
The SCI has agreed to use the symptom index for BPH, which has been developed by the AUA
Measurement Committee, as the official worldwide symptoms assessment tool for patients
suffering from prostatism.
The SCI recommends that physicians consider the following components for a basic diagnostic
workup: history; physical exam; appropriate labs, such as U/A, creatine, etc.; and DRE or other
evaluation to rule out prostate cancer

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