Latin American study on patient acceptance of the International Prostate Symptom Score (IPSS) in the evaluation of symptomatic benign prostatic hyperplasia

Objectives. To determine the acceptance of the self-administered International Prostate Symptom Score (IPSS) by people of differing educational levels in two different countries. Methods. The questionnaire adopted by the World Health Organization and known as the IPSS attempts to measure the severity of lower urinary tract symptoms in men with benign prostatic hyperplasia. An international study was performed in Brazil and Argentina and included 768 patients. The IPSS was self-administered and used to evaluate and quantify the clinical symptoms resulting from benign prostatic hyperplasia. The patients were asked not to answer any questions that they did not clearly understand or about which they were unsure of the information they should give. The patients were assessed into two subgroups according to their level of education. The Brazilian group consisted of 458 men in which subgroup 1 was composed of 244 (53%) men who had an elementary school education, whereas subgroup 2 consisted of 214 (47%) men who had a higher education level, including a university degree. The Argentinian group consisted of 310 patients, 158 (51%) of whom had an elementary school education, whereas the remaining 152 (49%) had received higher education, including a university degree. Results. A total of 77 men (16.8%), 35 (45.5%) from subgroup 1 and 42 (54.5%) from subgroup 2, failed to complete the questionnaire. The difference between the two subgroups was not significant. A total of 189 questions were not answered. There was no significant difference among the three questions most frequently unanswered by each subgroup. A total of 40 (12.9%) men filled out the questionnaire incompletely, 31 (77.5%) in the lower-education subgroup and 9 (22.5%) in the higher-education subgroup. An incomplete questionnaire was more frequent among the patients with lower education (P <0.01). Conclusions. In spite of the cultural variations, there was no significant difference in the number of patients unable to answer the questionnaire in the two countries. Copyright 1997 by Elsevier Science Inc.