International Prostate Symptom Score (I-Pss)
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1
2International Prostate Symptom Score (I-PSS)
Patient Name: ______________________ Date of birth: ________ Date completed _______
About
Less than
Less than
More
In the past
Your
Not at
Half
Almost
1 in 5
Half the
than Half
month:
All
the
Always
score
Times
Time
the Time
Time
1. Incomplete Emptying
How often have you had the
0
1
2
3
4
5
sensation of not emptying
your bladder?
2. Frequency
How often have you had to
0
1
2
3
4
5
urinate less than every two
hours?
3. Intermittency
How often have you found
0
1
2
3
4
5
you stopped and started again
several times when you
urinated?
4. Urgency
How often have you found it
0
1
2
3
4
5
difficult to postpone
urination?
5. Weak Stream
0
1
2
3
4
5
How often have you had a
weak urinary stream?
6. Straining
0
1
2
3
4
5
How often have you had to
strain to start urination?
None
1 Time
2 Times
3 Times
4 Times
5 Times
7. Nocturia
How many times did you
0
1
2
3
4
5
typically get up at night to
urinate?
Total I-PSS
Score
Score:
1-7: Mild
8-19: Moderate
20-35: Severe
Quality of Life Due to
Delighted
Pleased
Mostly
Mixed
Mostly
Unhappy
Terrible
Urinary Symptoms
Satisfied
Dissatisfied
If you were to spend the rest of
your life with your urinary
0
1
2
3
4
5
6
condition just the way it is now,
how would you feel about that?
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0 votes
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Parent category: Life