IPSS - Specialist Urology Clinic

International Prostate Symptom Score

Date

Time

:

SurveyID

	Not At All	Less Than 1 Time In 5	Less Than Half The Time	About Half The Time	More Than Half The Time	Almost Always
Incomplete Emptying: Over the past month, how often have you had a sensation of not emptying your bladder completely after you finish urinating?
Frequency: Over the past month, how often have you had to urinate again less than two hours after you have finished urinating?
Intermittency: Over the past month, how often have you found you stopped and started again several times when you urinated?
Urgency: Over the past month, how often have you found it difficult to postpone urination?
Weak Stream: Over the last month, how often have you had a weak urinary stream?
Straining: Over the past month, how often have you had to push or strain to begin urination?

Urinary Symptoms

	None	Once	Twice	3 times	4 times	5 or more
Nocturia: Over the past month how many times did you most typically get up each night to urinate from the time you went to bed until the time you got up in the morning?

Nocturia

Quality of Life due to Urinary Symptoms

Specialist Urology Clinic

Specialist urology care for adults in Sydney, with a focus on urinary symptoms, prostate conditions, kidney stones, male sexual health, incontinence, pelvic health and reconstructive urology.

	Delighted	Pleased	Mostly satisfied	Mixed	Mostly Unhappy	Unhappy	Terrible
If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that?

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Specialist Urology Clinic

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