Impact of surgical treatment on nocturia in men with benign prostatic obstruction

OBJECTIVES To validate the International Consultation on Incontinence Nocturia Quality-of-life (NQoL) questionnaire in Italian (IT-NQoL) and use it to evaluate the impact of surgical treatment on nocturia in men with lower urinary tract symptoms related to benign prostatic obstruction (LUTS/BPO). PATIENTS AND METHODS All men attending one urological unit between November 2004 and April 2005 were enrolled in the study. They were assessed in two groups; those with and with no LUTS/BPO. An Italian translation of the NQoL was devised, and patients then completed this and validated Italian versions of the International Prostate System Score (IPSS), the Pittsburg Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Clinical, laboratory and instrumental data from each patient were recorded. The patients with LUTS/BPO then had surgical treatment, and 6 months later those with LUTS/BPO were asked to complete all the questionnaires again to evaluate the test sensitivity to change. RESULTS Of the 109 patients enrolled in the study, 61 were affected by LUTS/BPO and 48 were not. Cronbach's alpha for the IT-NQoL was 0.943 (95% confidence interval, CI, 0.922-0.959; P < 0.001) and the intra-class correlation coefficient was 0.999 (95% CI 0.998-0.999; P < 0.001) for the total IT-NQoL score. The correlation between the test and the re-test was statistically significant (P < 0.001; r = 0.999) for all items. The mean (SD) IT-NQoL score showed an improvement in QoL from before, at 23.4 (10.1), to after treatment, at 3.09 (2.48) (P < 0.001). In the LUTS/BPO group, the IT-NQoL correlated with the number of times when waking to urinate (Pearson's coefficient 0.80, P < 0.001). There was also a correlation for ESS (0.796) and for the seven PSQI subscales (0.614, both P < 0.001). The decrease in sleep quality, duration and efficiency resulted in an increase in daytime sleepiness (r = 0.639, 0.642). At the 6-month follow-up, all questionnaire results were statistically different from those before treatment. CONCLUSIONS The IT-NQoL is the first validated translation of the primary instrument into another language. This version is easy to use and has the same characteristic validity as the English version. Using the IT-NQoL showed that surgical treatment determines a decrease in the nocturia rate and an increase in QoL. There was also a significant increase in QoL after treatment as assessed by all the other questionnaires.