Correlation between visual and international prostate symptom scores in grading lower urinary tract symptoms for benign prostatic hyperplasia at Muhimbili national hospital

Abstract

BACKGROUND: Benign prostatic hyperplasia (BPH) prevalence varies by ethnicity, with risk increasing in aging men. The visual prostate symptom score (VPSS) offers a practical alternative to the International Prostate Symptom Score (IPSS), especially for elderly patients, but its validation in Tanzania and correlation with IPSS remain underexplored. OBJECTIVES: This study conducted a comparative analysis of IPSS and VPSS in Tanzanian patients, assessing lower urinary tract symptoms (LUTS) and BPH severity before and after treatment at Muhimbili National Hospital's Urology Department. METHODOLOGY: This longitudinal observational study included both inpatients and outpatients at MNH in Dar es Salaam, examining the correlation between VPSS and IPSS for grading LUTS in BPH patients aged 40 years and above. Prostate volume was measured using transabdominal ultrasound. Participants completed Swahili versions of the 7-item IPSS and 4-item VPSS. Data were collected before treatment and at the six-month follow-up, with surgical patients and deceased patients excluded from follow-up analysis. Statistical analysis was performed using SPSS version 27. RESULTS: In a study of 137 BPH patients with LUTS, aged 62-76 years (median 70), prostate volume significantly decreased from 49.0 mL before treatment to 35.0 mL after treatment. Most patients (94.2%) were literate in Swahili, with significant differences in completing IPSS on the basis of literacy (p = 0.042) but no difference in completing VPSS (p = 0.999). Both the IPSS and VPSS improved significantly after treatment, with strong correlations before (r = 0.648) and after treatment (r = 0.732), confirming their reliability in assessing LUTS severity. CONCLUSION: This study showed that VPSS effectively evaluates LUTS severity in BPH patients, correlating well with IPSS, even in illiterate patients. VPSS's reliability suggests its utility in routine practice, enhancing symptom monitoring and treatment outcomes in BPH management.