How often have you had the sensation of not emptying your bladder?
0 Not at All
1 Less than 1 in 5 Times
2 Less than Half the Time
3 About Half the Time
4 More than Half the Time
5 Almost Always
How often have you had to urinate less than every two hours?
0 Not at All
1 Less than 1 in 5 Times
2 Less than Half the Time
3 About Half the Time
4 More than Half the Time
5 Almost Always
How often have you found you stopped and started again several times when you urinated?
0 Not at All
1 Less than 1 in 5 Times
2 Less than Half the Time
3 About Half the Time
4 More than Half the Time
5 Almost Always
How often have you found it difficult to postpone urination?
0 Not at All
1 Less than 1 in 5 Times
2 Less than Half the Time
3 About Half the Time
4 More than Half the Time
5 Almost Always
How often have you had a weak urinary stream?
0 Not at All
1 Less than 1 in 5 Times
2 Less than Half the Time
3 About Half the Time
4 More than Half the Time
5 Almost Always
How often have you had to strain to start urination?
0 Not at All
1 Less than 1 in 5 Times
2 Less than Half the Time
3 About Half the Time
4 More than Half the Time
5 Almost Always
How many times did you typically get up at night to urinate?
None
1 Time
2 Times
3 Times
4 Times
5 Times
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?
0 Delighted
1 Pleased
2 Mostly Satisfied
3 Mixed
4 Mostly Dissatisfied
5 Unhappy
6 Terrible
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