Objective To evaluate the efficacy of visual analog scale international prostate symptom score (VAS-IPSS) in patients with benign prostate hyperplasia (BPH).Methods Three hundred and ninety patients with BPH were recruited to participate in this study and were randomly assigned to one of two groups:the standard IPSS group and the VAS-IPSS group.In each group,sub-groups were further divided to non-interpretation arm (A) and interpretation arm ( B),based on the availability of medical professionals to interpret patientsˊ VAS-IPSS score.In the same way,the similar sub-groups were established in VAS-IPSS group with non-interpretation arm (C) and interpretation arm (D).All the patients were required to fill out the same questionnaires at first consultation and second consultation with an interval of two weeks.Eventually,all the data were collected and analyzed.Results The ICC index was as follows for arms A through D:0.87 (95％CI0.72-0.94); 0.88 (95％CI0.74-0.95); 0.82 (95％CI0.59-0.92); 0.97(95％ CI 0.93-0.99).The optimal prediction factor for arm A was frequency (F =14.70,P =0.010)and the sub-optimal was nocturia ( F =12.10,P =0.000) and urgency ( F =11.80,P =0.000).The optimal prediction factor for arm B was nocturia ( F =6.02,P =0.000 ) and the sub-optimal was urinary incontinence ( F =5.79,P =0.008 ).The optimal prediction factor for arm C was nocturia ( F =30.98,P =0.000) and the sub-optimal was urinary incontinence ( F =22.42,P =0.000).The optimal prediction factor for arm D was nocturia ( F =20.20,P =0.000) and the sub-optimal was urinary incontinence ( F =18.00,P =0.000) and weak urine steam (F =15.30,P =0.000).Conclusions VAS-IPSS is more stable than the standard IPSS.The questionnaire explanation to patients is helpful for improving the VASIPSS stability.