This questionnaire is used to refine the symptoms of prostate disease, such as
- prostate cancer
Answer each question by marking the selected answer as indicated. If you are not sure how to answer a question, please choose the answer that best reflects your opinion.
1. How often do you have in the last month there was a feeling of incomplete emptying of the bladder after urination?
(Circle one digit).
- There was - 0 points
- One urination (once a day) - 1 point
- Less than half of urination - 2 points
- In about half of urination - 3 points
- More than half of urination - 4 points
- Almost always - 5 points
2. How often do you have over the past four weeks, there need to urinate sooner than 2 hours after the last urination?
(Circle one digit).
- There was - 0 points
- One urination (once a day) - 1 point
- Less than half of urination - 2 points
- In about half of urination - 3 points
- More than half of urination - 4 points
- Almost always - 5 points
3. How often during the last month was interrupted urination?
(Circle one digit).
- There was - 0 points
- One urination (once a day) - 1 point
- Less than half of urination - 2 points
- In about half of urination - 3 points
- More than half of urination - 4 points
- Almost always - 5 points
4. How often during the past month did you find it difficult to temporarily refrain from urinating when an urge?
(Circle one digit).
- It was not 0
- There was - 0 points
- One urination (once a day) - 1 point
- Less than half of urination - 2 points
- In about half of urination - 3 points
- More than half of urination - 4 points
- Almost always - 5 points
5. How often during the past month did you feel the pressure of weak urinary stream?
(Circle one digit).
- There was - 0 points
- One urination (once a day) - 1 point
- Less than half of urination - 2 points
- In about half of urination - 3 points
- More than half of urination - 4 points
- Almost always - 5 points
6. How often have you had to make an effort during the last month and tense to begin urination?
(Circle one digit).
- There was - 0 points
- One urination (once a day) - 1 point
- Less than half of urination - 2 points
- In about half of urination - 3 points
- More than half of urination - 4 points
- Almost always - 5 points
7. How many times a night you usually have to get up in the last month to help?
(Circle one digit).
It was not 0
- There was - 0 points
- One urination (once a day) - 1 point
- Less than half of urination - 2 points
- In about half of urination - 3 points
- More than half of urination - 4 points
- Almost always - 5 points
Total ____________ points.
transcript
Score Sum obtained:
- minor symptoms - 0-7 points;
- Moderate - 8-19 points;
- expressed - 20-35 points.
