Madsen and Iversen developed a clinical evaluation sheet that can be used to identify patients with benign prostatic hypertrophy who are candidates for surgery.
(1) symptoms
(2) history of previous urinary tract infection (UTI)
(3) residual urine
(4) trabeculations on cystoscopy
(5) visual obstruction seen during cystoscopy
(6) bladder stones seen on cystoscopy
(7) azotemia or hydronephrosis
Parameter
Finding
Points
symptoms
none (symptom score 0)
0
mild (symptom score 1 – 9)
1
moderate (symptom score 10 – 20)
5
severe (symptom score > 20)
10
previous UTI
no
0
yes
3
complete retention
none
0
single
5
repeated
10
residual urine
< 30 mL
0
30 – 100 mL
3
101 – 500 mL
4
> 500 mL
5
trabeculations on cystoscopy
none
0
mild
1
moderate
3
severe
5
visual obstruction
absent
0
present
3
bladder stones
absent
0
present
5
azotemia or hydronephrosis
absent
0
present
10
clinical evaluation score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 51
• A score >= 10 indicates a patient who is a candidate for surgery.
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