Teillac Pierre, Rozet François, Terrier Nicolas, Mongiat-Artus Pierre, Rambeaud Jean-Jacques
Service d'Urologie, Hôpital Saint-Louis, Paris, France.
Prog Urol. 2004 Sep;14(4):493-500; discussion 499.
One half of French patients over the age of 50 with BPH are not diagnosed. Real difficulties are also currently encountered in the use of the I-PSS in general practice. In this context, the objective of this pilot study was to evaluate the concordance between the I-PSS score and a visual analogue scale (VAS), proposed as a new, precise and easy to use aid to the diagnosis of BPH.
Sixty five patients (mean age: 66 +/- 9 years, mean I-PSS: 13.6 +/- 7.0) recruited by two urology departments quantified their urinary symptoms by answering the question "How much difficulty do you have problems to urinate?": 7 patients used a 10 cm and a 35 cm VAS, 30 patients used a 15 cm VAS and 28 patients used a 20 cm VAS. All patients also completed the self-administered I-PSS questionnaire.
The VAS scores were independent the patient's age. The 4 classes of I-PSS severity were also represented in the VAS groups (p=0.999). The strongest correlation with the I-PSS score was observed with the 20 cm VAS (R=0.91, p<0.0001). This coefficient was 0.26, 0.67 and 0.72 for the 10 cm, 15 cm and 35 cm VAS, respectively. A very close correlation was observed between the evaluation on the 20 cm VAS and the classes of the I-PSS score. Finally, the relationship between the I-PSS subscores and the 20 cm VAS was statistically significant (p<0.0001) with high correlation coefficients (R=0.75 and R=0.87 for irritative and obstructive symptoms, respectively). This VAS did not appear to favour one type of symptoms over another.
This pilot study on a small number of patients showed that a 20 cm VAS can constitute a simple and precise aid to the detection of BPH. These results must now be validated by a large-scale study, under real general practice conditions.
50岁以上的法国良性前列腺增生(BPH)患者中有一半未被诊断出来。目前在全科医疗中使用国际前列腺症状评分(I-PSS)也遇到了实际困难。在此背景下,这项试点研究的目的是评估I-PSS评分与视觉模拟量表(VAS)之间的一致性,VAS被提议作为一种新的、精确且易于使用的辅助工具用于BPH的诊断。
由两个泌尿外科招募的65名患者(平均年龄:66±9岁,平均I-PSS:13.6±7.0)通过回答“您排尿有多大困难?”这一问题来量化他们的泌尿系统症状:7名患者使用10厘米和35厘米的VAS,30名患者使用15厘米的VAS,28名患者使用20厘米的VAS。所有患者还完成了自我填写的I-PSS问卷。
VAS评分与患者年龄无关。I-PSS严重程度的4个类别在VAS组中也都有体现(p = 0.999)。观察到与I-PSS评分相关性最强的是20厘米的VAS(R = 0.91,p < 0.0001)。对于10厘米、15厘米和35厘米的VAS,该系数分别为0.26、0.67和0.72。在20厘米VAS上的评估与I-PSS评分类别之间观察到非常密切的相关性。最后,I-PSS子评分与20厘米VAS之间的关系具有统计学意义(p < 0.0001),相关系数较高(刺激性症状和梗阻性症状的R分别为0.75和0.87)。这种VAS似乎对一种症状类型并不比另一种症状类型更有利。
这项对少数患者的试点研究表明,20厘米的VAS可以构成一种简单而精确的辅助工具用于BPH的检测。现在必须在实际的全科医疗条件下通过大规模研究来验证这些结果。