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IPSS “bother question” score predicts health-related quality of life better than total IPSS score

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Abstract

Objective

The objective of this study was to investigate the role of bothersomeness of urinary symptoms on the general health-related quality of life (HRQoL) of patients with benign prostatic hyperplasia. We hypothesised that a higher International Prostate Symptom Score (IPSS) would be associated with a higher score on the IPSS bother question (IPSS-BQ), and a higher IPSS-BQ score would be the dominant factor associated with poorer general HRQoL.

Materials and methods

A case–control, cross-sectional study design was used. Patients were selected according to strict inclusion and exclusion criteria and stratified by IPSS severity group (controls: IPSS < 8; moderately symptomatic: IPSS = 8–18; and severely symptomatic: IPSS > 18). The IPSS-BQ was used to analyse bothersomeness of urinary symptoms. A standardised, multidimensional measure of HRQoL (RAND-36) was used. Data were collected on prostate size, uroflowmetry parameters, prostate specific antigen and comorbidities that were quantified using the Charlson Index and the American Association of Anaesthesiologists (ASA) score. Multiple linear regression models were used to assess the impact of bothersomeness of urinary symptoms on physical and mental HRQoL. Cohen’s d was used to determine the effect size.

Results

We included 83 patients in the statistical analysis. Linear regression analyses showed that the IPSS was not an independent predictor of HRQoL. Only the highest IPSS-BQ score was associated with both worse physical (P = 0.021) and mental (P = 0.011) HRQoL in the final model. The effect sizes were small to moderate.

Conclusion

The IPSS-BQ score is an important predictor of HRQoL. The IPSS-BQ score as a proxy should be regarded as a standard outcome measure and reported in all LUTS-related research.

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Funding

None, except from the institutions mentioned on the front page.

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Authors and Affiliations

  1. Urology Department, Førde Central Hospital, Førde, Norway

    Florin V. Hopland-Nechita & John R. Andersen

  2. Western Norway University of Applied Sciences, Førde, Norway

    John R. Andersen

  3. Department of Clinical Medicine, University of Bergen, Bergen, Norway

    Christian Beisland

  4. Department of Urology, Haukeland University Hospital, Bergen, Norway

    Christian Beisland

Authors
  1. Florin V. Hopland-Nechita
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  2. John R. Andersen
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  3. Christian Beisland
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Contributions

FHN: project/protocol development, data collection and management, data analysis, manuscript writing/editing. JRA: project/protocol development, data management, data analysis, manuscript writing/editing, supervision. CB: project/protocol development, data analysis, manuscript writing/editing, supervision. All authors have approved the submitted version of the manuscript.

Corresponding author

Correspondence to Florin V. Hopland-Nechita.

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Conflicts of interest

None of the authors report conflicts of interest.

Ethical approval

The project is approved by the Norwegian South-East Regional Ethics Committee (REC reference number: 2018/114). In accordance with the approval, all participating patients signed an informed consent form prior to inclusion.

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Hopland-Nechita, F.V., Andersen, J.R. & Beisland, C. IPSS “bother question” score predicts health-related quality of life better than total IPSS score. World J Urol 40, 765–772 (2022). https://doi.org/10.1007/s00345-021-03911-2

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  • DOI: https://doi.org/10.1007/s00345-021-03911-2

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