PROSTATE ENLARGEMENT (BPH)

Please complete the following questionnaire for your personal evaluation and discuss with your doctor. Feel free call or email us, we would be happy to answer any of your questions.


1. INCOMPLETE EMPTYING
Over the last month or so, how often have you had a sensation of not emptying your bladder completely after you finished urinating?

1 2 3 4 5

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

1 2 3 4 5

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

1 2 3 4 5

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

1 2 3 4 5

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

1 2 3 4 5

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

1 2 3 4 5

7. SLEEPING
During the last month, 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?

1 2 3 4 5

 

Result:




What Your Result Means

Score

00 - 07 Mild

08 - 19 Moderate

20 - 35 Severe


SOURCE: Adapted from American Urological Association. Guideline on the Management of Benign Prostatic Hyperplasia (BPH), Linthicum, Md: American Urological Association Education and Research, Inc; 2003:1-22, 1-23, 3-51.