The International Prostate Symptom Score (IPSS) is a tool used to screen for and evaluate the severity of benign prostatic hyperplasia (BPH), a common condition in older men that involves enlargement of the prostate gland. The IPSS is also useful in monitoring the efficacy of treatment for BPH.
The score is based on a questionnaire that assesses urinary symptoms and their impact on quality of life. The questionnaire consists of seven questions related to lower urinary tract symptoms (LUTS), which include:
- Frequency: The frequency of urination.
- Nocturia: The need to wake up at night to urinate.
- Weak urinary stream: The perceived strength of the urine stream.
- Hesitancy: The delay and difficulty in initiating urination.
- Intermittency: Stopping and starting again while urinating.
- Incomplete emptying: The sensation of not completely emptying the bladder.
- Urgency: The urgent need to urinate.
Each question is scored from 0 to 5, with 0 indicating not experiencing the symptom and 5 indicating experiencing the symptom almost always or always. The total score can range from 0 (no symptoms) to 35 (severe symptoms).
In addition to these seven questions, there is an eighth question that is not included in the total score but is used to assess the patient’s quality of life due to urinary symptoms. This question asks the patient to rate, on a scale from 0 (delighted) to 6 (terrible), their overall satisfaction with their urinary situation.
The IPSS helps healthcare providers to:
- Diagnose BPH and distinguish it from other conditions like prostate cancer.
- Determine the severity of symptoms and their impact on a patient’s life.
- Guide treatment decisions based on symptom severity.
- Monitor the effectiveness of treatment over time.
The IPSS is a simple, self-administered questionnaire widely used in clinical practice for men reporting lower urinary tract symptoms.