Douglas F. Milam M.D.

Urologic Surgery

  • Home
  • About Us
  • Surgical ProceduresClick to open the Surgical Procedures menu
    • Urethral Stricture Repair
    • Surgical Procedures to Improve Continence in Men
    • Penile Implant
    • Surgical Treatment of Peyronie's Disease
  • Evaluation of Voiding DysfunctionClick to open the Evaluation of Voiding Dysfunction menu
    • Incontinence in Men
    • Urinary Retention
    • Severe Lower Urinary Tract Symptoms
    • Urinary Frequency, Urgency, and Urge Incontinence
    • Urodynamic Testing
    • Cystoscopy
  • Patient InformationClick to open the Patient Information menu
    • IPSS-AUA Symptom Score
    • Sexual Function Questionnaire
    • Deactivate a Urinary Sphincter
    • VPEC
    • Overnight Surgical Stay
    • Post-operative Instructions Urethral Stricture Repair
    • Post-operative Instructions Penile Implant
    • Post-operative Instructions Artificial Urinary Sphincter
    • Post-operative Instructions Placement of Male Sling
    • Post-operative Instructions Penile Curvature Repair
    • Post-procedure Instructions Vasectomy
    • Mechanism of Erection
    • Statement on Urologic Pain
  • Schedule a Consultation
  • DirectionsClick to open the Directions menu
    • Vanderbilt Clinic Location
    • Cool Springs Location
    • Main Operating Rooms
  • Urologic Images
  • Web References

IPSS-AUA Symptom Score

 

        

              

 

           

IPSS/AUA SYMPTOM SCORE

 

 

                DATE:   ______ /_______/_______      

 

 

 

           

 

 

 

                         Place Sticker Here

URINARY SYMPTOM SCORE

 

                                                                                              less                            more

                                                                                         than          than         about           than

                                                                         not at       1 time       half the     half the       half the       almost

                                                                           all            in 5          time          time            time         always

1. Over the past month or so, how

    often have you had a sensation of

    not emptying your bladder

    completely after you finish urinating?                0           1               2              3              4              5

 

2. Over the past month or so, how

    often have you had to urinate again

    less than two hours after you

    finished urinating?                                              0           1               2              3              4              5

 

3. Over the past month or so how

    often have you found you stopped

    and started again several times

    when you urinated?                                            0           1               2              3              4              5

 

4.  Over the past month or so, how

     often have you found it difficult to

     postpone urination?                                            0           1               2              3              4              5

 

5.  Over the past month or so, how

     often have you had a weak urinary

     stream?                                                              0           1               2              3              4              5

 

6.  Over the past month or so, how

     often have you had to push or strain

     to begin urination?                                              0           1               2              3              4              5

 

7.  Over the last month, how many times did you most typically get up to urinate from the time you went

     to bed at night until the time you got up in the morning?

     0  None        1  One time           2   Two times         3 Three times          4  Four times          5 Five times

 

                                                                       

AUA Symptom Score = Sum of questions 1 –7 ___________.

 

 

 

8. Quality of life due to urinary symptoms

 

Delighted

 

Pleased

 

Mostly satisfied

 

Mixed – about equally satisfied and  dissatisfied

 

Mostly dissatisfied

 

Unhappy

 

Terrible

 

 

 

If you were to spend the rest of your life with your urinary condition the way it is now, how

would you feel about that?                                  

 

     0

 

   1

 

    2

 

     3

 

     4

 

       5

 

      6

 

 

Reference:  Barry MJ, et al. (1992). American Urological Association symptom index for benign prostatic hyperplasia. Journal of Urology, 148(5): 1549–1557.

 

 

Copyright 2010-2015  Milam Urology. All rights reserved.