Validation of a patient reported outcome questionnaire for assessing success of endoscopic prostatectomy

PURPOSE: Several international committees involved in establishing standards of care have recommended that patients undergoing surgery for bladder outlet obstruction should be assessed with patient reported outcomes (PRO). The Patient Global Impression of Improvement (PGI-I) is an instrument designed to measure a patients interpretation of symptom changes following intervention. The objective of this study was to validate the PGI-I as a PRO assessment following surgery for bladder outflow obstruction (BOO) in men with benign prostatic hyperplasia (BPH). METHODS: Men undergoing photoselective vaporisation of the prostate were followed prospectively. Pre- and postoperative International Prostate Symptom Score (IPSS), Quality of life (QoL) index, peak urinary flow (Qmax), and postvoid residual (PVR) assessments were done. The PGI-I was conducted and correlated at 3 months postoperatively to changes in IPSS, QoL, Qmax, and PVR. RESULTS: One hundred and sixty-six consecutive patients were included. Following surgery, IPSS and QoL improved by 11 and 2.4 points (P<0.0001). PGI-I was found to correlate with postoperative changes in IPSS and QoL (Pearson correlation, 0.47 and 0.58, respectively; P<0.0001). CONCLUSIONS: This is the first study to validate the PGI-I as a PRO measure to surgery for BOO. This suggests a potential for the PGI-I to be used to assess surgical therapies for BPH and may be a valuable addition for measuring outcomes in clinical trials evaluating surgical interventions for BPH.