MDCalc

American Urological Association Symptom Index (AUA-SI)/International Prostate Symptom Score (IPSS)

Measures severity of benign prostatic hyperplasia (BPH) symptoms.

Incomplete emptying: How often have you had the sensation of not emptying your bladder?

Frequency: How often have you had to urinate less than every two hours?

Intermittency: How often have you found you stopped and started again several times when you urinated?

Urgency: How often have you found it difficult to postpone urination?

Weak stream: How often have you had a weak urinary stream?

Straining: How often have you had to strain to start urination?

Nocturia: How many times do you typically get up at night to urinate?

Quality of Life Due to Urinary Symptoms (optional)

If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that?

Result:

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Advice

This tool should not be the sole determinant in BPH management but should be part of a comprehensive evaluation.

Management
  • Mild symptoms (score 0–7): Often managed with behavioral and lifestyle modifications and routine monitoring.
  • Moderate to severe symptoms (score 8–35): 
    • Consider alpha-blockers, 5-alpha-reductase inhibitors, antimuscarinics, beta-3 agonists, or combination therapy. 
    • For severe cases unresponsive to medical therapy, surgical options may be explored.
  • Regularly reassess the patient’s score to monitor their response to treatment.
  • Consider urology referral if symptoms are severe, progressive, or if there is suspicion of another pathology, like prostate cancer.
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