International Prostate Symptom Score (IPSS) IPSS Your Full Name * Date of Birth Your GP * Choose from the listDr CashDr WallsDr BoydDr CalvertDr MacSorleyDr CarswellDr DuffyDr DickieDr MaysonDr GilhespyDr PophamANP Claire Hill Incomplete emptying * (Over the past month, how often have you had a sensation of not emptying your bladder completely after you finish urinating?)0 - Not at all1 - Less than 1 time in 52 - Less than half the time3 - About half the time4 - More than half the time5 - Almost always Frequency * (Over the past month, how often have you had to urinate again less than two hours after you finished urinating?)0 - Not at all1 - Less than 1 time in 52 - Less than half the time3 - About half the time4 - More than half the time5 - Almost always Intermittency * (Over the past month, how often have you found you stopped and started again several times when you urinated?)0 - Not at all1 - Less than 1 time in 52 - Less than half the time3 - About half the time4 - More than half the time5 - Almost always Urgency * (Over the last month, how often have you found it difficult to postpone urination?)0 - Not at all1 - Less than 1 time in 52 - Less than half the time3 - About half the time4 - More than half the time5 - Almost always Weak stream * (Over the past month, how often have you had a weak urinary stream?)0 - Not at all1 - Less than 1 time in 52 - Less than half the time3 - About half the time4 - More than half the time5 - Almost always Straining * (Over the past month, how often have you had to push or strain to begin urination?)0 - Not at all1 - Less than 1 time in 52 - Less than half the time3 - About half the time4 - More than half the time5 - Almost always Nocturia * (Over the past month, 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 - None1 - 1 time2 - 2 times3 - 3 times4 - 4 times5 - 5 times or more Total score: 0-7 Mildly symptomatic; 8-19 moderately symptomatic; 20-35 severely symptomatic. Quality of life due to urinary symptoms * (If you were to spend the rest of your life with your urinary condition the way it is now, how would you feel about that?)0 - Delighted1 - Pleased2 - Mostly satisfied3 - Mixed - about equally satisfied and dissatisfied4 - Mostly dissatisfied5 - Unhappy6 - Terrible reCAPTCHA Submit Start Over Δ
