Validation of the Urgency, Weak stream, Incomplete emptying, and Nocturia (UWIN) score compared with the American Urological Association Symptoms Score in assessing lower urinary tract symptoms in the clinical setting

Urology. 2014 Jan;83(1):181-5. doi: 10.1016/j.urology.2013.08.039. Epub 2013 Oct 16.


Objective: To validate the Urgency, Weak stream, Incomplete emptying, and Nocturia (UWIN) survey for patients with lower urinary tract symptoms (LUTS) by comparison with the American Urological Association Symptoms Score (AUA-SS). The hypothesis is that the UWIN will perform as well as the AUA-SS in assessing LUTS symptoms and quality of life. The AUA-SS is complex for many patients and can be misunderstood. The UWIN questionnaire was developed to serve as a simpler and shorter version of the AUA-SS, with the intent of improving accuracy and minimizing error in assessing LUTS. The UWIN consists of 4 questions scored 0-3 to give a maximum score of 12.

Methods: We screened 700 patients in the urology clinic between 2011 and 2012. We enrolled 593 patients who completed the AUA-SS survey and UWIN in the same clinic visit. The AUA-SS and UWIN responses were evaluated using Spearman correlation coefficients and Bland-Altman graphs.

Results: Correlation coefficients were calculated between the corresponding AUA-SS and UWIN items on 593 matched surveys, demonstrating a strong correlation coefficient of 0.81 or greater for each question, which was statistically significant (P <.0001). The correlation coefficient between the total scores of the AUA and UWIN was 0.89 (P <.01). A second analysis was performed using Bland-Altman plots between AUA-SS and UWIN including total score, quality of life, and categories, which showed a good agreement.

Conclusion: The UWIN appears to provide results comparable to the AUA-SS, while using a simpler format and taking less time to complete.

Publication types

  • Comparative Study
  • Validation Study

MeSH terms

  • Aged
  • Humans
  • Lower Urinary Tract Symptoms / complications
  • Lower Urinary Tract Symptoms / diagnosis*
  • Male
  • Nocturia / etiology
  • Prospective Studies
  • Severity of Illness Index
  • Societies, Medical
  • Symptom Assessment / methods*
  • United States
  • Urination Disorders / etiology
  • Urology