ABSTRACT
Because the prostate surrounds the urethra, patients who have prostatic diseases most frequently complain of micturition-related symptoms. These have been subdivided into irritative (storage) and obstructive (voiding) symptoms. Irritative symptoms have the most impact on the patient’s quality of life. To quantitate the severity of symptoms, a numerical symptom-scoring system was first devised by a subcommittee of the American Urological Association (AUA)37,38 and then adopted by the International Consensus Committee (ICC) as the International Prostate Symptom Score (IPSS; Figure 57). As an adjunct to the symptom score, there is also a single question that attempts to evaluate the impact of the symptoms on the quality of life.
Other symptoms that are suggestive of either prostatic or bladder disease, but which are not encompassed by the IPSS, include perineal pain, hematuria, hemospermia and, in the case of metastatic prostate cancer, sudden onset of lower back or pelvic pain.
