Male Urinary Tract (IPSS)

If you have been advised by the surgery to submit Male Urinary Tract (IPSS) review please use this form.

Male Urinary Tract (IPSS)

Male Urinary Tract (IPSS)

About You

Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.

Urinary Tract Review

How often have you had the sensation of not emptying your bladder? *
How often have you had to urinate less than every 2 hours? *
How often have you found you stopped and started again several times when you urinated? *
How often have you found it difficult to postpone urination? *
How often have you had a weak urinary stream? *
How often have you had to strain to start urination? *
How many times do you typically get up at night to urinate? *

Quality of Life due to urinary symptoms

If you were spend the rest of your life with your urinary condition just the way it is now, how would you feel about that? *
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