Usefulness of Voiding Symptom Score and Uroflowmetry as the Screening Methods for Patients with Prostatitis Syndrome

Abstract

Purpose: Recently, urine reflux into prostate during abnormal micturition has been proved and suggested to be an important pathogenetic factor that evoked the symptoms of prostatitis syndrome. The evaluation of voiding dysfunction in these patients may give the useful information to select the treatment methods or the next step of study. The objectives of this study was to evaluate the usefulness of voiding symptom score and uroflowmetry as the screening methods for patients with nonbacterial prostatitis syndrome. Materials and Methods: For patients with prostatitis syndrome, evaluations of urine, prostatic secretion, voiding symptom scores(IPSS: international prostate symptoms score), and uroflowmetry were performed. Patients were divided into 3 groups according to the patterns of uroflow curve[type N; normal bell shape with Qmax(maximal flow rate)>20ml/sec, type I; irregular shape, regardless of Qmax, type P; plateau shape with Qmax<15ml/sec]. For patients with curve patterns of type I and P, α-blockers were tried initially for 1-2 months and the effectiveness of α-blockers according to the changes of IPSS, Qmax and patterns of uroflow curve was estimated. Patients with the pattern of type N and non-responders to α-blockers were further investigated to rule out any other cause. Results: Among total 64 patients, 55 patients(86%) showed the abnormal uroflow curves (Type I or P). 34(61.8%) of these 55 patients responded to α-blockers with changes of IPSS from 18.3 to 8.1(p<0.001) and of Qmax from 13.9ml/sec to 20.0ml/sec(p<0.001). The response to α-blockers was expected highly in group of type I with more than 10ml/sec of Qmax and less than 20points of IPSS(14.7folds). Of the 9 of type N patients, 6 were revealed to have idiopathic detrusor instability and 18 of 21 non-responders to α-blockers were diagnosed to have the bladder neck obstruction. Conclusions: The results that the effectiveness to α-blockers and the possibility of other disease could be characterized by IPSS and uroflowmetry suggest IPSS and uroflowmetry may be the useful screening methods for patients with prostatitis syndrome.