IPSS (Mild 0-7, Mod 8-18, Sev- 19-35)

1. 2. 3. 4. 5. 6.

Incomplete emptying: Over the past month, how often have you had the sensation of not emptying your bladder completely after you have finished urinating? Frequency: Over the past month, how often have you had to urinate again less than 2 hours after you finished urinating? Intermittency: Over the past month, how often have you stopped and started again several times when urinating? Urgency: Over the past month, how often have you found it difficult to postpone urination? Weak stream: Over the past month, how often have you had a weak urinary stream? Nocturia: Over the past month, how many times did you most typically get up to urinate from the time you went to bed until the time you got up in the morning? 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 Straining: Over the past month, how often have you had to push or strain to begin urination? Never = 0 once = 1 twice = 2 thrice = 3 4 times or more = 4 5 times or more = 5)

7.

Bother score: How would you feel if you were to spend the rest of your life with your urinary condition just the way it is now? Delighted = 0, pleased = 1, mostly satisfied = 2, mixed = 3, mostly dissatisfied = 4, unhappy = 5, terrible = 6

IPSS (Mild 0-7, Mod 8-18, Sev- 19-35)

8. 9. 10. 11. 12. 13.

Incomplete emptying: Over the past month, how often have you had the sensation of not emptying your bladder completely after you have finished urinating? Frequency: Over the past month, how often have you had to urinate again less than 2 hours after you finished urinating? Intermittency: Over the past month, how often have you stopped and started again several times when urinating? Urgency: Over the past month, how often have you found it difficult to postpone urination? Weak stream: Over the past month, how often have you had a weak urinary stream? Nocturia: Over the past month, how many times did you most typically get up to urinate from the time you went to bed until the time you got up in the morning? 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 Straining: Over the past month, how often have you had to push or strain to begin urination? Never = 0 once = 1 twice = 2 thrice = 3 4 times or more = 4 5 times or more = 5)

14.

Bother score: How would you feel if you were to spend the rest of your life with your urinary condition just the way it is now? Delighted = 0, pleased = 1, mostly satisfied = 2, mixed = 3, mostly dissatisfied = 4, unhappy = 5, terrible = 6

IPSS (Mild 0-7, Mod 8-18, Sev- 19-35)

15. 16. 17. 18. 19. 20.

Incomplete emptying: Over the past month, how often have you had the sensation of not emptying your bladder completely after you have finished urinating? Frequency: Over the past month, how often have you had to urinate again less than 2 hours after you finished urinating? Intermittency: Over the past month, how often have you stopped and started again several times when urinating? Urgency: Over the past month, how often have you found it difficult to postpone urination? Weak stream: Over the past month, how often have you had a weak urinary stream? Nocturia: Over the past month, how many times did you most typically get up to urinate from the time you went to bed until the time you got up in the morning? 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 Straining: Over the past month, how often have you had to push or strain to begin urination? Never = 0 once = 1 twice = 2 thrice = 3 4 times or more = 4 5 times or more = 5)

21.

Bother score: How would you feel if you were to spend the rest of your life with your urinary condition just the way it is now? Delighted = 0, pleased = 1, mostly satisfied = 2, mixed = 3, mostly dissatisfied = 4, unhappy = 5, terrible = 6

IPSS (Mild 0-7, Mod 8-18, Sev- 19-35)

22. 23. 24. 25. 26. 27.

Incomplete emptying: Over the past month, how often have you had the sensation of not emptying your bladder completely after you have finished urinating? Frequency: Over the past month, how often have you had to urinate again less than 2 hours after you finished urinating? Intermittency: Over the past month, how often have you stopped and started again several times when urinating? Urgency: Over the past month, how often have you found it difficult to postpone urination? Weak stream: Over the past month, how often have you had a weak urinary stream? Nocturia: Over the past month, how many times did you most typically get up to urinate from the time you went to bed until the time you got up in the morning? 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 Straining: Over the past month, how often have you had to push or strain to begin urination? Never = 0 once = 1 twice = 2 thrice = 3 4 times or more = 4 5 times or more = 5)

28.

Bother score: How would you feel if you were to spend the rest of your life with your urinary condition just the way it is now? Delighted = 0, pleased = 1, mostly satisfied = 2, mixed = 3, mostly dissatisfied = 4, unhappy = 5, terrible = 6