IPSS May Not Tell the Whole Story: Integrating ICIQ-MLUTS for Comprehensive LUTS Assessment

Area of Science:

• Urology
• Andrology
• Gerontology

Background:

• Male lower urinary tract symptoms (LUTS) significantly impact quality of life.
• The International Prostate Symptom Score (IPSS) is widely used for LUTS assessment.
• Limitations exist in the IPSS's ability to capture the full spectrum of LUTS.

Purpose of the Study:

• To evaluate the limitations of the IPSS in assessing male LUTS.
• To determine if the ICIQ-MLUTS identifies clinically relevant symptoms missed by the IPSS.
• To explore the utility of the IPSS as a preliminary screening tool for LUTS.

Main Methods:

• 239 Turkish men (aged 50-80) with LUTS completed validated Turkish versions of IPSS and ICIQ-MLUTS.
• Symptoms not covered by IPSS, including various incontinence types and postvoid dribbling, were identified.
• Multivariate logistic regression and ROC analyses identified predictors of overlooked symptoms.

Main Results:

• 32.6% of participants reported significant symptoms not captured by IPSS.
• Higher urgency scores on IPSS (≥3) and severe IPSS classification were associated with increased likelihood of overlooked symptoms.
• ROC analysis indicated acceptable predictive performance for urgency scores and severe IPSS classification.

Conclusions:

• The IPSS alone may fail to detect a substantial portion of clinically relevant LUTS, especially incontinence and post-micturition symptoms.
• Patients with high urgency or severe LUTS burden warrant further evaluation beyond IPSS.
• The IPSS can serve as an effective triage instrument in the initial assessment of male LUTS.