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International Prostate Symptom Score (IPSS)

Also called IPSS, AUA symptom index, AUA-SI, I-PSS

Seven-item symptom score (0–35) for lower urinary tract symptoms in men, with a separate bother question.

Incomplete emptying
Frequency (again within 2 h)
Intermittency
Urgency
Weak stream
Straining
Nocturia (times per night)
Quality of life — if you had to live with these symptoms

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Formula and scoring

Seven items, each 0–5 (incomplete emptying, frequency, intermittency, urgency, weak stream, straining, nocturia). Total 0–35: 0–7 mild, 8–19 moderate, 20–35 severe.

Exam and ward pearls

  • IPSS = the AUA Symptom Index (Barry 1992) plus the eighth quality-of-life question, adopted by WHO.
  • Storage items: frequency, urgency, nocturia. Voiding items: incomplete emptying, intermittency, weak stream, straining.
  • After prostatectomy the mean AUA score fell from 17.6 to 7.1 at 4 weeks in the validation study.

When not to rely on it

  • Measures symptom severity, not the cause — it does not distinguish bladder outlet obstruction from detrusor underactivity or overactive bladder.

Source

  1. Barry MJ, Fowler FJ, O’Leary MP, et al. The American Urological Association symptom index for benign prostatic hyperplasia. J Urol. 1992;148(5):1549-57. doi:10.1016/s0022-5347(17)36966-5 · PMID 1279218
  2. HealthLink BC / Healthwise. International Prostate Symptom Score (IPSS) — questions, answer scale and severity bands. Link

Formula and cut-offs checked against these sources on 8 Nov 2026. Educational tool for clinicians; it does not replace clinical judgement.

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