Accurate evaluation of lower urinary tract symptoms (LUTS) in women is crucial for proper diagnosis and management. This study aimed to compare the diagnostic efficacy of the International Prostate Symptom Score (IPSS) and the Bladder Quality of Life Self-Assessment Questionnaire (CACV) in assessing obstructive and storage symptoms. Additionally, optimal cutoff points for uroflowmetry (Qmax) and detrusor pressure at maximum flow (PdetMax) were determined to identify women with obstructive urinary syndrome.

A cross-sectional study was conducted on adult women with LUTS. The IPSS and CACV questionnaires were administered, and complete urodynamic studies were performed. ROC curves were used to analyze the sensitivity and specificity of both questionnaires in evaluating obstructive and storage symptoms. Optimal cutoff points for Qmax and PdetMax were also identified using ROC analysis.

The analysis showed that the CACV outperformed the IPSS in assessing obstructive symptoms (sensitivity 85%, specificity 79%, AUC 0.89 vs. 0.78; p<0.05). Conversely, the IPSS demonstrated better performance in evaluating storage symptoms (sensitivity 80%, specificity 75%, AUC 0.82 vs. 0.77; p<0.05).

The following clinically useful cutoff points were identified:

Parameter	                  Cutoff Point	Sensitivity (%)	Specificity (%)
Qmax (ml/s)	                        ≤ 12	                84	                      76
PdetMax (cmH₂O)	        ≥ 25	                82	                      80

Our findings revealed distinct strengths for each questionnaire. The CACV demonstrated superior accuracy in identifying obstructive symptoms, such as weak urinary flow or difficulty initiating urination, with an excellent AUC of 0.89. On the other hand, the IPSS proved more effective in evaluating storage symptoms, such as urinary urgency and increased frequency, with a good AUC of 0.82. These results highlight the importance of tailoring diagnostic approaches to the predominant symptom type, ensuring a more precise and personalized assessment.

Moreover, the identification of clinically relevant cutoff points for Qmax (≤12 ml/s) and PdetMax (≥25 cmH₂O) offers practical tools for the early detection of obstructive urinary syndromes in women. These thresholds provide a clear framework for guiding urodynamic evaluations and distinguishing between obstructive and non-obstructive causes of LUTS, further enhancing diagnostic accuracy.

The comparative analysis underscores the complementary roles of the CACV and IPSS in LUTS assessment. While the CACV excels in diagnosing obstructive symptoms, the IPSS is better suited for storage-related issues. By integrating these tools into clinical practice alongside the established urodynamic cutoff points, healthcare providers can achieve a more targeted and effective evaluation of LUTS in women, ultimately improving patient outcomes and quality of life.