Desired Outcomes

• Reducing or eliminating obstructive and irritative voiding symptoms. An improvement in the AUA Symptom Score should be observed. Drug treatment with an a-adrenergic antagonist or 5a-reductase inhibitor is expected to reduce the AUA Symptom Score by 30% to 50%, improve peak and mean urinary flow rate by 1 to 3 mL/s, and decrease PVR to normal (less than 50 mL total) when compared to pre-treatment baseline values. The AUA Symptom Score may not correlate with response to therapy.

• Slowing disease progression. When compared to baseline, symptoms and serum BUN and creatinine should improve, stabilize, or decrease to the normal range with treatment.

• Preventing disease complications and reducing the need for surgical intervention.

• Avoiding or minimizing adverse treatment effects.

• Providing economical therapy.

• Maintaining or improving quality of life.

Table 52-1 Questions to Determine the AUA Symptom Score

Directions for the patient: The patient should be asked to respond to each question based on the absence or presence of symptoms over the past month. For each question, the patient can respond using a 1-5 scale, where 0 = not at all or none; 1 = less than 1 time in 5; 2 = less than half of the time; 3 = about half of the time; 4 = more than half of the time; and 5 = almost always

Directions for the clinician: After the patient completes the questionnaire, the scores for individual items should be tallied for a final score. Scores of 0-7 = mild symptoms; scores of 8-19 = moderate symptoms; scores more than 20 = severe symptoms

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