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World J Clin Urol. Sep 16, 2026; 15(2): 123397
Published online Sep 16, 2026. doi: 10.5410/wjcu.123397
Symptom scores and clinical measures in benign prostatic hyperplasia
Jackson Kakooza, Theoneste Hakizimana, Michael Mugenyi, Prosper Akankwasa, Catherine R Lewis, Enock Mukiibi, Joseph Ssebamala, Sura Daniels Elias, Eltahir Ahmed Eltahir, Nick Okwi, Bienfait Vahwere Mumbere
Jackson Kakooza, Michael Mugenyi, Enock Mukiibi, Joseph Ssebamala, Sura Daniels Elias, Eltahir Ahmed Eltahir, Nick Okwi, Bienfait Vahwere Mumbere, Department of Surgery, Kampala International University, Western Campus, PO Box 71, Ishaka Bushenyi, Uganda
Theoneste Hakizimana, Prosper Akankwasa, Department of Obstetrics and Gynecology, Kampala International University, Western Campus, PO Box 71, Ishaka Bushenyi, Uganda
Catherine R Lewis, Department of Surgery, St. Joseph’s Hospital Kitovu, PO Box 524, Masaka, Uganda
Co-corresponding authors: Catherine R Lewis and Bienfait Vahwere Mumbere.
Author contributions: Kakooza J and Mumbere BV designed the research study; Kakooza J, Hakizimana T, Mugenyi M, Akankwasa P, Lewis CR, Mukiibi E, Ssebamala J, Elias SD, Eltahir EA, Okwi N and Mumbere BV performed the research; Kakooza J, Hakizimana T and Mumbere BV extracted and analyzed the data; Kakooza J drafted the manuscript; Hakizimana T, Mugenyi M, Akankwasa P, Lewis CR, Mukiibi E, Ssebamala J, Elias SD, Eltahir EA, Okwi N and Mumbere BV critically revised the manuscript; Lewis CR and Mumbere BV validated and supervised the research. All authors have read and approved the final manuscript.
AI contribution statement: During the preparation of this work, the author(s) used Rayyan with AI-assisted prioritization in order to assist with title and abstract screening. All inclusion and exclusion decisions were made independently by the reviewers based on predefined criteria. Claude was used to help develop search terms. However, the final search strategy was designed and approved by the authors. All aspects of study design, data extraction, analysis, and interpretation were conducted by the authors, who take full responsibility for the content of the published article.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Bienfait Vahwere Mumbere, Chairman, Department of Surgery, Kam
pala International University, Western Campus, PO Box 71, Ishaka Bushenyi, Uganda.
drbienfaitmumbere@gmail.com
Received: May 18, 2026
Revised: May 30, 2026
Accepted: June 11, 2026
Published online: September 16, 2026
Processing time: 122 Days and 10 Hours
BACKGROUND
Benign prostatic hyperplasia commonly causes lower urinary tract symptoms and impaired quality of life (QoL). The International Prostate Symptom Score (IPSS), prostate volume (PV), and post-void residual (PVR) urine are routinely assessed together, but their correlations have not been comprehensively pooled. We hypothesized that symptom scores would correlate strongly with QoL but only moderately with anatomical and functional measures.
AIM
To determine pooled correlations between symptom scores, QoL, PV, and PVR urine in men with benign prostatic hyperplasia.
METHODS
PubMed, Scopus, Web of Science, and Lens.org were searched through December 2025. Eligible studies reported Pearson or Spearman correlation coefficients between the IPSS and QoL, PV, or PVR urine. Correlations were Fisher’s Z-transformed and pooled using restricted maximum likelihood random-effects meta-analysis. Heterogeneity, publication bias, subgroup patterns, and leave-one-out sensitivity were assessed.
RESULTS
Twenty-eight studies involving 4814 participants from 14 countries were included. The pooled correlation between the IPSS and QoL was strong [r = 0.713, 95% confidence interval (CI): 0.557-0.820; k = 5; I2 = 3.26%; P < 0.001]. PV showed a moderate-to-large correlation with symptom severity (r = 0.457, 95%CI: 0.257-0.619; k = 12; I2 = 38.37%; P < 0.001). PVR urine showed a moderate correlation with symptom severity (r = 0.363, 95%CI: 0.150-0.543; k = 11; I2 = 51.18%; P = 0.001). No compelling publication bias was detected.
CONCLUSION
Symptom scores strongly reflect QoL impairment, whereas PV and PVR urine provide complementary, non-redundant clinical information.
Core Tip: Benign prostatic hyperplasia causes lower urinary tract symptoms and impaired quality of life. This meta-analysis shows that the International Prostate Symptom Score is strongly associated with quality-of-life impairment, while prostate volume and post-void residual urine are moderately and incompletely associated with symptom severity. The findings support integrated assessment using symptom scoring, prostate volume, post-void residual urine, intravesical prostatic protrusion grading, and uroflowmetry, where available, rather than reliance on one parameter.
