Netto Júnior N R, D'Ancona C A, de Lima M L
Division of Urology, University of Campinas Medical Center, São Paulo, Brazil.
J Urol. 1996 Jan;155(1):200-2. doi: 10.1097/00005392-199601000-00072.
We examined the relationship between the International Prostatic Symptom Score (I-PSS) and the occurrence of bladder outlet obstruction caused by benign prostatic hyperplasia (BPH).
The American Urological Association developed a questionnaire to quantify the severity of symptoms resulting from BPH. A further question relating the impact of BPH to the quality of life was subsequently added. This questionnaire has been adopted by the World Health Organization and is known as the I-PSS. There are 4 questions related to obstructive symptoms and 3 related to irritative symptoms. Scores of 0 to 7, 8 to 19 and 20 to 35 represent mild, moderate and severe symptoms, respectively. During an 18-month interval the I-PSS questionnaire was administered to 258 patients 50 to 81 years old (mean age 63 years) with BPH. A pressure-flow study was used to determine the presence of bladder outlet obstruction in 227 patients. Based on the scores, the patients were divided into 31 with mild, 116 with moderate and 111 with severe obstruction. The pressure-flow study was not conducted on patients with a mild symptom score.
Of the patients with a severe symptom score 92 (82.9%) had bladder outlet obstruction, compared to 62 (53.4%) with a moderate symptom score. Statistical analysis (Pearson chi-square test) showed that there was a significant positive correlation between the symptoms and the presence of bladder outlet obstruction. Thus, when the I-PSS was greater than 28, the probability of bladder outlet obstruction was more than 0.91. Stratification of the results according to the obstructive (0 to 20) and irritative (0 to 15) symptoms of the I-PSS yielded a significant positive correlation between obstructive symptoms and the presence of bladder outlet obstruction. Thus, when the obstructive symptom score was greater than 15, the probability of bladder outlet obstruction was greater than 0.91.
When the total I-PSS is greater than 28 or the obstructive symptom score is greater than 15, a pressure-flow study must be avoided.
我们研究了国际前列腺症状评分（I-PSS）与良性前列腺增生（BPH）所致膀胱出口梗阻发生情况之间的关系。
美国泌尿外科学会制定了一份问卷，用于量化BPH所致症状的严重程度。随后又增加了一个关于BPH对生活质量影响的问题。该问卷已被世界卫生组织采用，即I-PSS。有4个问题与梗阻性症状相关，3个与刺激性症状相关。评分0至7、8至19和20至35分别代表轻度、中度和重度症状。在18个月的时间里，对258例年龄在50至81岁（平均年龄63岁）的BPH患者进行了I-PSS问卷调查。采用压力-流率研究来确定227例患者是否存在膀胱出口梗阻。根据评分，将患者分为轻度梗阻31例、中度梗阻116例和重度梗阻111例。对症状评分轻度的患者未进行压力-流率研究。
重度症状评分的患者中，92例（82.9%）存在膀胱出口梗阻，中度症状评分的患者中这一比例为62例（53.4%）。统计分析（Pearson卡方检验）表明，症状与膀胱出口梗阻的存在之间存在显著正相关。因此，当I-PSS大于28时，膀胱出口梗阻的概率大于0.91。根据I-PSS的梗阻性（0至20）和刺激性（0至15）症状对结果进行分层，梗阻性症状与膀胱出口梗阻的存在之间存在显著正相关。因此，当梗阻性症状评分大于15时，膀胱出口梗阻的概率大于0.91。
当I-PSS总分大于28或梗阻性症状评分大于15时，必须避免进行压力-流率研究。
