Please select the score that best describes how much you have been bothered by each symptom.
How bothered have you been by the following?
0 = Not at all
1 = A little bit
2 = Somewhat
3 = Quite a bit
4 = A great deal
5 = A very great deal
Frequent urination during the day
0
1
2
3
4
5
An uncomfortable urge to urinate
0
1
2
3
4
5
A sudden urge to urinate with little or no warning
0
1
2
3
4
5
Accidental loss of small amounts of urine
0
1
2
3
4
5
Nighttime urination
0
1
2
3
4
5
Being woken up at night by the need to urinate
0
1
2
3
4
5
An uncontrollable urge to urinate
0
1
2
3
4
5
Urine loss associated with a strong urge to urinate
0
1
2
3
4
5
Are you:
Male
Female
Advertisement