Similarity of the American Urological Association Symptom Index among men with benign prostate hyperplasia (BPH), urethral obstruction not due to BPH and detrusor hyperreflexia without outlet obstruction

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Abstract
Objective To compare the specificity of the American Urological Association (AUA) Symptom Index for benign prostatic hyperplasia (BPH) versus other urodynamically verified micturitional dysfunction in men. Patients and methods Fifty-seven consecutive men who had been referred for video-urodynamic evaluation of voiding symptoms were evaluated. The patients were divided into three groups: (i) BPH group (n = 24): (ii) non-BPH obstructed group (n = 20; nine bladder neck obstruction, 11 bulbous urethral stricture); and (iii) detrusor hyper-reflexia group: detrusor hyperreflexia without outlet obstruction (n = 13). Results The mean AUA symptom score for the BPH group was 18.9 (range 7–28). The mean score for the 20 non-BPH obstructed group was 17.6 (range 4–28) and the mean score for the 13 men with detrusor hyper-reflexia was 20.5 (range 12–27). There was no statistical difference in the AUA symptom score among the three groups. Conclusion The AUA Symptom Index does not specifically identify BPH or bladder outlet obstruction. The index cannot differentiate the site of obstruction as noted by the similar scores among men with BPH from those with bladder neck obstruction and urethral strictures. Moreover, The AUA Symptom Index scores are similar between men with voiding symptoms secondary to bladder dysfunction and bladder outlet obstruction.