Association of International Prostate Symptom Score Storage vs. Voiding Symptoms with Uroflowmetry Parameters


Authors : Pethiyagoda, A.U.B.; Dunuwila, K.B.S.; Sunilarathne, W.; Arshana, M.M.F.; Chandrasekara, C.A.H.M.D.A.

Volume/Issue : Volume 10 - 2025, Issue 12 - December


Google Scholar : https://tinyurl.com/2f4s6k28

Scribd : https://tinyurl.com/yc3pbnnf

DOI : https://doi.org/10.38124/ijisrt/25dec1182

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.


Abstract : Lower urinary tract symptoms (LUTS) are a common clinical presentation, typically assessed subjectively using the International Prostate Symptom Score (IPSS), while objective evaluation is performed by uroflowmetric studies. Although numerous studies have explored the association between LUTS severity and uroflowmetric parameters globally, a significant research gap remains in correlating individual LUTS components with objective uroflowmetric findings. This study aims to investigate the relationship between specific LUTS domains, as assessed by the IPSS, and corresponding uroflowmetric parameters. This study examines how IPSS storage and voiding scores relate to uroflowmetry measures {maximum flow rate (Qmax), average flow rate (Qavg), voided volume}and compares their associations. Research was conducted as cross-sectional descriptive study including 208 patients aged 18–94 years presenting with LUTS for the first time. Assessment of LUTS were performed using the IPSS questionnaire, categorizing patients as having mild, moderate, or severe symptoms. Objective evaluation was carried out through uroflowmetry, Qmax, Qave, and total voided volume (TV), followed by post-void residual volume (PVRV) assessment via ultrasonography. The relationships between subjective symptom severity and objective uroflowmetric parameters were then analyzed. The mean age of the study population was 61.52 ± 13.67 years, with the majority of participants (79.3%) being over 50 years of age. Statistical analysis demonstrated significant differences in all four uroflowmetric parameters between the mild vs. severe and moderate vs. severe LUTS groups. Furthermore, the presence of specific symptoms : incomplete evacuation, poor stream, intermittency, straining, and increased daytime frequency was associated with significant decrease in Qmax, Qave, and significant increase in PVRV in participants with symptoms compared to participants without these symptoms. This study demonstrates a clear association between the IPSS assessed LUTS severity and objective assessment of uroflowmetric parameters. As symptom severity increased, Qmax, Qave, and TV declined, while PVRV rose significantly. Among individual symptoms, incomplete evacuation and increased daytime frequency showed the strongest correlations with poor uroflowmetric outcomes, indicating impaired bladder emptying. These findings highlight the value of uroflowmetry as an objective complement to the IPSS, particularly for assessing voiding symptoms and prioritizing patients for further evaluation in resource-limited settings.

Keywords : LUTS, IPSS, Uroflowmetry, Storage Symptoms, Voiding Symptoms.

References :

  1. D. E. Irwin et al., ‘Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study’, European urology, vol. 50, no. 6, pp. 1306–1315, 2006.
  2. W. Schäfer et al., ‘Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies’, Neurourology and Urodynamics: Official Journal of the International Continence Society, vol. 21, no. 3, pp. 261–274, 2002.
  3. M. A. Sheikh, S. Ali, and A. Khan, ‘Uroflowmetry: nomograms in healthy young Pakistani men’, JPMA. The Journal of the Pakistan Medical Association, vol. 74, no. 10, pp. 1806–1810, 2024.
  4. H. Itoh et al., ‘Significant relationship of time-dependent uroflowmetric parameters to lower urinary tract symptoms as measured by the International Prostate Symptom Score’, International journal of urology, vol. 13, no. 8, pp. 1058–1065, 2006.
  5. S. Agrawal, S. Reddy, R. Ln, D. Bolbandi, and Others, ‘Lower urinary tract symptoms evaluation with uroflowmetry in patients with benign prostatic hyperplasia’, 2024.
  6. J. K. Wanigasuriya, E. S. Wijewickrama, W. M. Jayasekara, and N. Gunarathna, ‘Lower urinary tract symptoms; an undetected cause for morbidity in adults’, The Ceylon Medical Journal, vol. 52, no. 3, pp. 86–89, 2007.
  7. M. Oelke, K. Höfner, U. Jonas, J. J. De la Rosette, D. T. Ubbink, and H. Wijkstra, ‘Diagnostic accuracy of noninvasive tests to evaluate bladder outlet obstruction in men: detrusor wall thickness, uroflowmetry, postvoid residual urine, and prostate volume’, European urology, vol. 52, no. 3, pp. 827–835, 2007.
  8. V. Abhulimen and J. E. Raphael, ‘Correlation between Uroflowmetry and International Prostate Symptoms Score in the evaluation of Nigerian men with Benign Prostatic Enlargement’, Nigerian Medical Journal, vol. 63, no. 5, pp. 219–225, 2022.
  9. K. Ezz el Din, L. Kiemeney, M. De Wildt, F. M. J. Debruyne, and J. de la Rosette, ‘Correlation between uroflowmetry, prostate volume, postvoid residue, and lower urinary tract symptoms as measured by the International Prostate Symptom Score’, 1996.

Lower urinary tract symptoms (LUTS) are a common clinical presentation, typically assessed subjectively using the International Prostate Symptom Score (IPSS), while objective evaluation is performed by uroflowmetric studies. Although numerous studies have explored the association between LUTS severity and uroflowmetric parameters globally, a significant research gap remains in correlating individual LUTS components with objective uroflowmetric findings. This study aims to investigate the relationship between specific LUTS domains, as assessed by the IPSS, and corresponding uroflowmetric parameters. This study examines how IPSS storage and voiding scores relate to uroflowmetry measures {maximum flow rate (Qmax), average flow rate (Qavg), voided volume}and compares their associations. Research was conducted as cross-sectional descriptive study including 208 patients aged 18–94 years presenting with LUTS for the first time. Assessment of LUTS were performed using the IPSS questionnaire, categorizing patients as having mild, moderate, or severe symptoms. Objective evaluation was carried out through uroflowmetry, Qmax, Qave, and total voided volume (TV), followed by post-void residual volume (PVRV) assessment via ultrasonography. The relationships between subjective symptom severity and objective uroflowmetric parameters were then analyzed. The mean age of the study population was 61.52 ± 13.67 years, with the majority of participants (79.3%) being over 50 years of age. Statistical analysis demonstrated significant differences in all four uroflowmetric parameters between the mild vs. severe and moderate vs. severe LUTS groups. Furthermore, the presence of specific symptoms : incomplete evacuation, poor stream, intermittency, straining, and increased daytime frequency was associated with significant decrease in Qmax, Qave, and significant increase in PVRV in participants with symptoms compared to participants without these symptoms. This study demonstrates a clear association between the IPSS assessed LUTS severity and objective assessment of uroflowmetric parameters. As symptom severity increased, Qmax, Qave, and TV declined, while PVRV rose significantly. Among individual symptoms, incomplete evacuation and increased daytime frequency showed the strongest correlations with poor uroflowmetric outcomes, indicating impaired bladder emptying. These findings highlight the value of uroflowmetry as an objective complement to the IPSS, particularly for assessing voiding symptoms and prioritizing patients for further evaluation in resource-limited settings.

Keywords : LUTS, IPSS, Uroflowmetry, Storage Symptoms, Voiding Symptoms.

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Paper Submission Last Date
31 - January - 2026

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