1. |
Over the past month, how often have you had a sensation of not emptying your bladder completely after you finish urinating? |
0 |
1 |
2 |
3 |
4 |
5 |
 |
2. |
Over the past month, how often have you had to urinate again less than two hours after you finished urinating? |
0 |
1 |
2 |
3 |
4 |
5 |
 |
3. |
Over the past month, how often have you found you stopped and started again several times when you urinated? |
0 |
1 |
2 |
3 |
4 |
5 |
 |
4. |
Over the last month, how difficult have you found it to postpone urination? |
0 |
1 |
2 |
3 |
4 |
5 |
 |
5. |
Over the past month, how often have you had a weak urinary stream? |
0 |
1 |
2 |
3 |
4 |
5 |
 |
6. |
Over the past month, how often have you had to push or strain to begin urination? |
0 |
1 |
2 |
3 |
4 |
5 |
 |
7. |
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? |
None 0 |
1 time 1 |
2 times 2 |
3 times 3 |
4 times 4 |
5 times + 5 |
Total score: |
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