IPSS Questionnaire

IPSS Questionnaire for urinary symptoms possibly due to the prostate

A symptom score helps evaluate the severity of your symptoms when due to the benign enlargement of the prostate and quantify how much bother it causes.
The IPSS (International Prostate Symptom Score) is the name for one of these questionnaires. Download here (PDF file).

The symptoms are graded as:

  • Mild: score 1 to 8
  • Moderate: score 9 to 19
  • Severe: score 20 to 35


 


 

Not at all (0)

Less than 1 in 5 (1)

Less than half the time  (2)

About half the time (3)

More than half the time (4)

Almost always (5)

 

Over the past month, how often have you had a sensation of not emptying your bladder completely after you finish urinating?

 

 

 

 

 

 

 

Over the past month, how often have you to urinate again less than 2 hours after urinating?

 

 

 

 

 

 

 

Over the past month, how often have you found you stopped and started again several times when you urinate?

 

 

 

 

 

 

 

Over the past month, how often have you found it difficult to postpone urination?

 

 

 

 

 

 

 

Over the past month, how often have you had a weak urinary stream?

 

 

 

 

 

 

 

Over the past month, how often have you had to push or strain to begin urination?

 

 

 

 

 

 

 

Over the past month, how many times did you most typically get up to urinate from the time you went to bed at night until you got up in the morning?

0 /night

1 /night

2 /night

3 /night

4 /night

5 or more /night

 

Total Score 

 

 

 

 

 

 

 

 
If you had to spend the rest of your life with your condition as it now, how would you feel about it?

     

Delighted

Pleased

Mostly satisfied

Mixed (about equally satisfied and dissatisfied)

Mostly dissatisfied

Unhappy

Terrible