PCS03424048 - Microsite development-DRL

This BPH symptom score will help your doctor to evaluate your condition and understand your BPH symptom severity better. Answer each question by selecting the number corresponding to your symptom severity.

Note for Questions 1 to 6: 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

1. Incomplete Emptying: Over the past month, after you've urinated, do you often feel like your bladder is not completely empty?

0
1
2
3
4
5

2. Frequency: Over the past month, how often do you need to urinate less than once every 2 hours?

0
1
2
3
4
5

3. Intermittency: Over the past month, do you often find yourself stopping and starting again when you urinate?

0
1
2
3
4
5

4. Urgency: Over the past month, how often do you have a strong, sudden urge to urinate that you can't delay?

0
1
2
3
4
5

5. Weak Stream: Over the past month, do you find it hard to start urinating and had a weak urinary stream?

0
1
2
3
4
5

6. Straining: Over the past month, do you need to push or strain to pass urine?

0
1
2
3
4
5

7. Nocturia: Over the past month, how many times did you wake up at night to urinate?

0
1
2
3
4
5

Score: 1-7 : Mild BPH 8-19 : Moderate BPH 20-35 : Severe BPH

Your Score:

Note for Question 8: 0-Delighted; 1-Pleased; 2-Mostly satisfied; 3-Mixed (about equally satisfied and dissatisfied); 4-Mostly dissatisfied; 5-Unhappy; 6-Terrible

8. Quality of Life: How would you feel if your urinary condition stayed the same for the rest of your life?

Your Score:

9. Are you a sexually active male

Yes No

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