The International Prostate Symptom Score represents an important development in the understanding of benign prostatic hyperplasia (BPH) and its clinical management. This instrument provides reasonable reliability, content validity, and predictive validity. However, it is limited by a lack of concurrent validity so it can not be used to discriminate the voiding dysfunction associated with BPH from that associated with unrelated conditions. Psychometric properties of this symptom score are evaluated and suggestions provided for increased involvement for urologic nurses in its clinical application and future development.