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International prostate symptom score

I-PSS

Peer reviewed by Dr Doug McKechnie, MRCGPLast updated by Dr Hayley Willacy, FRCGPLast updated 1 Jun 2023

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Medical Professionals

Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European Guidelines. You may find one of our health articles more useful.

In this article:

See separate related Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms in Men articles.

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What is the international prostate symptom score (I-PSS)?

The International Prostate Symptom Score (I-PSS) is used in the assessment of lower urinary tract symptoms in men (LUTS).1 It is reliable, repeatable and has validity and has been translated into many languages.2 3 4 There are also smartphone applications.5

The tool is free to use and widely available.6

Contents of the I-PSS

There are seven questions about urological symptoms including:

  • Incomplete emptying.

  • Frequency.

  • Intermittency.

  • Urgency.

  • Strength of stream.

  • Straining.

  • Nocturia.

Each reply generates a score which generates a total. This is a useful, standardised tool for assessing the severity of the symptoms.

Continue reading below

Development of the I-PSS

The I-PSS was originally based on the American Urological Association seven-item symptom score (AUA-7).7 The 'quality of life' question was added by the World Health Organization when it was adopted by the International Consensus Committee as an international questionnaire for evaluating prostatic symptoms.

Although the single 'quality of life' question may not capture the full impact of prostate symptoms, it can be used as a starting point for a doctor-patient discussion on management.

Further reading and references

  1. International Prostate Symptom Score; Urological Sciences Research Foundation
  2. Arshad Z, Zaidi SZ, Jamshaid A; Development, validity and reliability of an URDU version of the International Prostate Symptom Score. J Pak Med Assoc. 2018 Feb;68(2):200-202.
  3. Taneja Y, Ram P, Kumar S, et al; Comparison of Visual Prostate Symptom Score and International Prostate Symptom Score in the evaluation of men with benign prostatic hyperplasia: A prospective study from an Indian population. Prostate Int. 2017 Dec;5(4):158-161. doi: 10.1016/j.prnil.2017.04.004. Epub 2017 Apr 22.
  4. Dun RL, Mao JM, Yu C, et al; Simplified Chinese version of the international prostate symptom score and the benign prostatic hyperplasia impact index: cross-cultural adaptation, reliability, and validity for patients with benign prostatic hyperplasia. Prostate Int. 2022 Sep;10(3):162-168. doi: 10.1016/j.prnil.2022.04.001. Epub 2022 May 10.
  5. Kim JH, Kwon SS, Shim SR, et al; Validation and reliability of a smartphone application for the International Prostate Symptom Score questionnaire: a randomized repeated measures crossover study. J Med Internet Res. 2014 Feb 10;16(2):e38. doi: 10.2196/jmir.3042.
  6. International Prostate Symptom Score; British Association of Urological Surgeons.
  7. Barry MJ, Fowler FJ Jr, O'Leary MP, et al; The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992 Nov;148(5):1549-57; discussion 1564.

Article history

The information on this page is written and peer reviewed by qualified clinicians.

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