The International Prostate Symptom Score (IPSS) Is an Inadequate Tool to Screen for Urethral Stricture Recurrence After Anterior Urethroplasty

Christopher A Tam; Sean P Elliott; Bryan B Voelzke; Jeremy B Myers; Alex J Vanni; Benjamin N Breyer; Thomas G Smith III; Christopher D McClung; Bradley A Erickson

doi:10.1016/j.urology.2016.04.006

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The International Prostate Symptom Score (IPSS) Is an Inadequate Tool to Screen for Urethral Stricture Recurrence After Anterior Urethroplasty

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The International Prostate Symptom Score (IPSS) Is an Inadequate Tool to Screen for Urethral Stricture Recurrence After Anterior Urethroplasty

Christopher A Tam, Sean P Elliott, Bryan B Voelzke, Jeremy B Myers, Alex J Vanni, Benjamin N Breyer, Thomas G Smith III, Christopher D McClung and Bradley A Erickson

Urology (Ridgewood, N.J.), Vol.95, pp.197-201

09/2016

DOI: 10.1016/j.urology.2016.04.006

PMCID: PMC5002376

PMID: 27109599

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Abstract

To validate the use of the International Prostate Symptom Score (IPSS) as a stand-alone tool to detect urethral stricture recurrence following urethroplasty. This study included 393 men who had undergone anterior urethroplasty and were enrolled in a multi-institutional outcomes study. Data analyzed included pre- and post-operative answers to the IPSS in addition to findings from a same- day cystoscopy. IPSS from men found to have cystoscopic recurrence were then compared to scores from those with successful repairs, and receiver operating characteristic curves were plotted to illustrate the predictive ability of these questions to screen for cystoscopic recurrence. Mean postoperative scores were lower (fewer symptoms) in successful repairs; IPSS improved from preoperative values regardless of recurrence. Successful repairs had significantly better degree of improvement in question #5 (assessing weak stream) compared to recurrences. Receiver operating characteristic curves demonstrated the highest area under the curve for the IPSS quality of life question (0.66) that alone outperformed the complete IPSS questionnaire (0.56). The IPSS had inadequate sensitivity and specificity to be used as a stand-alone screening tool for stricture recurrence in this large cohort of men, highlighting the need to continue development of a disease-specific, validated patient-reported outcome measure.

Recurrence

Urethra - surgery

Urethral Stricture - surgery

Urethral Stricture - diagnosis

Humans

Middle Aged

Urologic Surgical Procedures, Male - methods

Symptom Assessment

Adult

Male

Details

Title: Subtitle: The International Prostate Symptom Score (IPSS) Is an Inadequate Tool to Screen for Urethral Stricture Recurrence After Anterior Urethroplasty
Creators: Christopher A Tam - Department of Urology, University of Iowa, Iowa City, IA
Sean P Elliott - Department of Urology, University of Minnesota, Minneapolis, MN
Bryan B Voelzke - Department of Urology, University of Washington, Seattle, WA
Jeremy B Myers - Division of Urology, University of Utah, Salt Lake City, UT
Alex J Vanni - Lahey Hospital and Medical Center, Institute of Urology, Burlington, MA
Benjamin N Breyer - Department of Urology, University of California, San Francisco, CA
Thomas G Smith III - Department of Urology, Baylor University, Waco, TX
Christopher D McClung - Department of Urology, Ohio State University, Columbus, OH
Bradley A Erickson - Department of Urology, University of Iowa, Iowa City, IA. Electronic address: brad-erickson@uiowa.edu
Resource Type: Journal article
Publication Details: Urology (Ridgewood, N.J.), Vol.95, pp.197-201
DOI: 10.1016/j.urology.2016.04.006
PMID: 27109599
PMCID: PMC5002376
NLM abbreviation: Urology
ISSN: 0090-4295
eISSN: 1527-9995
Publisher: United States
Grant note: T35 HL007485 / NHLBI NIH HHS K12 DK083021 / NIDDK NIH HHS
Language: English
Date published: 09/2016
Academic Unit: Urology
Record Identifier: 9984051560702771

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