Objective: To develop and validate an Arabic version of the International Prostate Symptom Score (IPSS).
Patients, subjects and methods: An Arabic version of the IPSS (IPSS-Arb) was developed through a series of translations and modifications which involved the authors, urology and non-urology medical and nursing staff. The validity and reliability were assessed in 76 patients with urinary symptoms due to benign prostatic hyperplasia (BPH) and in 63 control subjects without BPH; 25 patients had transurethral resection of prostate (TURP) whereas the remaining 51 patients were treated with terazosin. The reliability of the IPSS-Arb was assessed by determining the internal consistency (Cronbach's alpha coefficient) and by assessing the test-retest reliability (intraclass correlation coefficient, ICC). Construct validity was assessed by determining the correlation between the IPSS-Arb scores and the quality-of-life question (QoL-Arb), and by determining the ability of the IPSS-Arb to discriminate between the patients and controls by calculating the area under the receiver operating characteristic (ROC) curve.
Results: The Cronbach's alpha coefficient (internal consistency) for the IPSS-Arb was 0.85, and 0.78-0.88 for the individual items. The test-retest reliability (ICC) was 0.88 (P < 0.001). In addition, the IPSS-Arb had a high correlation with the QoL-Arb (Spearman rank correlation coefficient 0.82, P = 0.01). The mean (sem, 95% confidence interval) area under the ROC curve for the IPSS-Arb was 0.93 (0.09, 0.89-0.97), whereas the area for its individual questions was 0.79-0.90. The IPSS-Arb also showed a high sensitivity to change. The mean (sd) IPSS-Arb scores before and after TURP were 23.1 (6.4) and 6.9 (1.8), respectively (P < 0.001); in the terazosin group, the scores were 12.6 (7.4) and 8.2 (4.0), respectively (P < 0.001).
Conclusions: The IPSS-Arb was shown to be a reliable and valid instrument for patients with BPH. We recommend using it for patient assessment and follow-up, and as a research tool in Arabic-speaking patients both in the Middle East and worldwide. In addition, this study provided another proof of the wide suitability of the IPSS among various nations worldwide.