Hesitancy or Straining, That Is the Question: Which Does Question 6 of the International Prostate Symptom Score...

Area of Science:

• Urology
• Medical Diagnostics
• Symptom Assessment

Background:

• Lower urinary tract symptoms (LUTS) affect many adults.
• Accurate symptom assessment is crucial for diagnosis and management.
• The International Prostate Symptom Score (IPSS) is widely used, with Question 6 (IPSS Q6) assessing initial straining.

Purpose of the Study:

• To evaluate the agreement between initial straining (IPSS Q6) and specific voiding symptoms: hesitancy, straining during voiding, and terminal straining.
• To assess the correlation of initial straining and hesitancy with other voiding symptoms.

Main Methods:

• Analysis of data from a nationwide Japanese survey on LUTS in adults.
• Weighted kappa coefficient used to evaluate agreement between symptoms.
• Spearman's rank correlation used to assess symptom correlations.

Main Results:

• Substantial agreement observed between initial straining and hesitancy (kappa 0.625-0.639) and straining during voiding (kappa 0.790-0.801) in both males and females.
• Initial straining and hesitancy showed moderate correlations with other voiding symptoms.
• Straining during voiding moderately correlated with intermittency.

Conclusions:

• IPSS Q6 demonstrates substantial agreement with both hesitancy and straining during voiding.
• Clinicians should consider IPSS Q6 as a representative measure for both hesitancy and straining during voiding.
• The findings support the utility of IPSS Q6 in assessing key aspects of voiding dysfunction.