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    Interventional procedure overview of transurethral water-jet ablation for lower urinary tract symptoms caused by benign prostatic hyperplasia

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    Outcome measures

    The main outcomes included IPSS, Qmax, PVR, PSA, retreatment rates and adverse events. Some of the measures used are detailed in the following paragraphs.

    IPSS

    The IPSS is a validated questionnaire often used to assess symptoms of BPH (it is also referred to as the American Urological Association BPH Symptom Score Index). It includes questions on incomplete bladder emptying, frequency, intermittency and urgency of urination, weak urine stream, straining to urinate and nocturia. Higher scores represent worse symptoms. In general, an IPSS symptom score of 0 to 7 indicates mild symptoms, 8 to 19 indicates moderate symptoms and 20 to 35 indicates severe symptoms. An additional question asks the respondent how they feel about their BPH symptoms and the response yields a score for quality of life (ranging from 0 to 6, with 0 representing 'delighted' and 6 representing 'terrible').

    Qmax

    In uroflowmetry, Q refers to the volume of fluid expelled by the urethra per unit time (flow rate). Qmax is the maximum measured value of the flow rate after correction for artefacts. It decreases with age and voided volume. A low Qmax value is commonly a sign of obstruction.

    IIEF

    The IIEF is a 15-item questionnaire used to assess male sexual function in 5 domains: erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. Each domain has its own score range and lower scores represent greater dysfunction:

    • Erectile function score: range 0 to 30 (scores of 24 or less represent increasing dysfunction)

    • Orgasmic function score: range 0 to 10 (scores of 8 or less represent increasing dysfunction)

    • Sexual desire score: range 0 to 10 (scores of 8 or less represent increasing dysfunction)

    • Intercourse satisfaction score: range 0 to 15 (scores of 12 or less represent increasing dysfunction)

    • Overall satisfaction score: range 0 to 10 (scores of 8 or less represent increasing dysfunction).

    ISI

    The ISI is a questionnaire composed of 2 items which assess the frequency (4 levels) and amount (3 levels) of urine leakage. The index value (1 to 12) is reached by multiplying the 2 items.

    MSHQ-EjD

    The MSHQ-EjD includes 3 questions relating to ejaculation dysfunction, including completeness of ejaculation, strength of ejaculation and volume of semen on ejaculation. Each question is scored 0 to 5, with lower scores indicating worse sexual function. An additional question measures how much the patient is bothered by his ejaculatory function on a scale from 0 to 5, with a higher score indicating greater bother.