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The Purpose is to determine your total symptom score to provide you and your doctor a general understanding of the severity of your symptoms. Your eventual treatment will be based on your doctor's overall assessment of your condition.

Click the point score for each of the 7 questions that most accurately corresponds to your urinary symptoms:

0 = Not at all
1= Less than 1 time in 5
2= Less than half the time
3= About half the time
4= More than half the time
5= Almost Always

1. During the last month or so, how often have you had the sensation of not emptying your bladder after you finished urinating?

0 1 2 3 4 5

2. During the last month or so, how often have you had to urinate again less than 2 hours after you finished urinating?

0 1 2 3 4 5

3. During the last month or so, how often have you stopped and started again several times when you urinated?

0 1 2 3 4 5

4. During the last month or so, how often have you found it difficult to postpone urination?

0 1 2 3 4 5

5. During the last month or so, how often have you had a weak urinary stream?

0 1 2 3 4 5

6. During the last month or so, how often have you had to push or strain to begin urination?

0 1 2 3 4 5

7. During the last month or so, how many times did you most typically get up to urinate from the time you went to bed at night until the time you got up in the morning? (Click the button which best represents the number of times you awake each night on average.)

0 1 2 3 4 5

Total your scores
from the 7 questions:

Symptom Score: 1-7 Mild 8-19 Moderate 20-45 Severe

 
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1130 S. Clifton Avenue | Wichita, Kansas | 316 260-4000 | Toll-free: 866 893-9313