Translation and Validation of the International Prostate Symptom Score (IPSS) in Chinese

Benign prostatic hyperplasia (BPH) is a common condition affecting aging males, leading to lower urinary tract symptoms (LUTS) that negatively impact quality of life. Language barriers may limit access to healthcare for Chinese-speaking patients. Our aim was to translate and validate the International Prostate Symptom Score (IPSS) in Chinese, ensuring it accurately captures LUTS severity and can be administered both in-clinic and remotely. The English IPSS was translated into simplified Chinese using forward-backward translation and assessed by Chinese-speaking urologists. An existing traditional Chinese version was also reviewed. A hybrid model (written survey in clinic, followed by a phone-administered survey) and a remote model (two phone-administered surveys) were used for validation. Internal validity was assessed using Cronbach’s alpha, test-retest reliability with Spearman’s correlation, and discriminant validity with T-Tests and ANOVA to compare LUTS severity groups between hybrid and remote models. A total of 115 patients were included, with 46 in the hybrid, 50 in the remote, and 19 in the control groups. Internal validity was acceptable, with Cronbach’s alpha of 0.848 (hybrid) and 0.734 (remote). Spearman’s correlation coefficients ranged from 0.43 to 0.91 (p < 0.001), demonstrating strong test-retest reliability. Pearson’s correlation of 0.986 confirmed consistency across survey administrations. ANOVA analysis (p = 0.000) showed significant differences in LUTS scores between mild, moderate and severe symptom groups, validating the Chinese IPSS’s ability to differentiate symptom severity. The Chinese translation of the IPSS is a valid and reliable tool for assessing LUTS in Chinese-speaking patients. Its successful validation in both hybrid and remote models ensures its utility in telehealth settings, allowing for improved patient assessment and management of BPH.