Comment on “Value of the Danish prostate symptom score compared to the AUA symptom score and pressure/flow studies in the preoperative evaluation of men with symptomatic benign hyperplasia,” Neurourol Urodynam (1998):17:9–18

✍ Scribed by Jesper Schou; Tage Hald; Jørgen Nordling

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 8 KB
• Volume: 17
• Category: Article
• ISSN: 0733-2467
• DOI: 10.1002/(sici)1520-6777(1998)17:6<637::aid-nau7>3.0.co;2-j

✦ Synopsis

One of the conclusions of this paper is that the Danish Prostatic Symptom score is a valid and sensitive questionnaire for the assessment of LUTS. We fully agree and recommend this questionnaire instead of the IPSS score, because it is more sensitive to changes after treatment/intervention [Flyger et al., 1996].

In the early days of the DAN-PSS era, we made a study of 50 patients that surprisingly suggested that this questionnaire was able to predict infravesical obstruction with an acceptable sensitivity and specificity [Schou et al., 1993]. Such a revolutionary finding had to be tested, and the same score limits were applied to a new series of 188 patients [Poulsen et al., 1994]. As expected, this large study showed no statistically significant correlations between the three factors in prostatic disease: hyperplasia, infravesical obstruction, and LUTS.

Therefore the conclusion of the second study invalidated the theory that DAN-PSS can predict infravesical obstruction. When we saw the above paper, we were first surprised that Jürgen Pannek et al. bothered to take up this theory again and next that the tests were performed on only 25 patients. This is only half the number included in our pilot study and one eighth of the patients in the second study.

In conclusion, it must be stated with no possible doubt: None of the present questionnaires concerning LUTS (including the DAN-PSS) can predict infravesical obstruction.