Core lower urinary tract symptom score (CLSS) for the assessment of female lower urinary tract symptoms: a comparative study

Int J Urol. 2011 Nov;18(11):778-84. doi: 10.1111/j.1442-2042.2011.02848.x. Epub 2011 Sep 23.


Objective: We have recently developed the core lower urinary tract symptom score (CLSS) questionnaire to readily address 10 important lower urinary tract symptoms (LUTS). The aim of the present study was to evaluate the performance of the CLSS in women compared with the International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS).

Methods: Three hundred and eighteen treatment-naïve consecutive female patients, including 48 controls, completed the three questionnaires. Quality of life (QOL) was determined as per the IPSS QOL Index. The clinical diagnoses were overactive bladder (n = 69), mixed incontinence (n = 42), stress incontinence (n = 17), pelvic organ prolapse (n = 56), interstitial cystitis (n = 31), bacterial cystitis (n = 16), underactive bladder (n = 16), and "other" (n = 23). Simple statistics and the relationship between symptom scores and poor QOL (QOL Index ≥ 4) were examined.

Results: All symptom scores were significantly increased in symptomatic women. The CLSS described the symptom profiles of patients with distinct conditions. The scores of corresponding symptoms on the three questionnaires were significantly correlated (r = 0.51-0.85; all P < 0.0001). Multivariate logistic regression modeling proved five CLSS symptoms (daytime frequency, nocturia, urgency incontinence, straining, and urethral pain) as independent predictors of poor QOL, with hazard ratios ranging from 2.0 to 4.2. The IPSS included only two (urgency and straining) significant symptoms.

Conclusions: The IPSS alone does not fully evaluate female LUTS, with a possible negative impact on QOL. Using the CLSS questionnaire would enable a simple and comprehensive assessment of female LUTS.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Logistic Models
  • Lower Urinary Tract Symptoms / diagnosis*
  • Middle Aged
  • Multivariate Analysis
  • Quality of Life
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Surveys and Questionnaires*
  • Young Adult