Urology General Medicine A

IPSS — International Prostate Symptom Score

7-item questionnaire for lower urinary tract symptoms (LUTS) in BPH. Guides treatment decisions.

Incomplete emptying: sensation of not fully emptying the bladder

Frequency: urinating again within 2 hours of last urination

Intermittency: stopping and starting several times while urinating

Urgency: difficult to postpone urination

Weak stream: weak urinary stream

Straining: straining to begin urination

Nocturia: number of times waking up to urinate per night

Score interpretation

Mild LUTS 0–7

IPSS 0–7: Mild symptoms

→ Watchful waiting; lifestyle advice (fluid, caffeine, evening fluid restriction); reassess in 12 months

Moderate LUTS 8–19

IPSS 8–19: Moderate symptoms

→ Alpha-blocker (tamsulosin) first-line; 5-alpha reductase inhibitor (finasteride) if large prostate; reassess in 4–6 weeks

Severe LUTS 20–35

IPSS 20–35: Severe symptoms

→ Medical therapy; urology referral; consider urodynamics; TURP if medical failure or retention/haematuria/renal impairment

Interpretation bands for the IPSS. Apply clinical judgement and local guidance.

Barry MJ, et al. The American Urological Association symptom index for benign prostatic hyperplasia. J Urol. 1992;148(5):1549-1557.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.