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International Prostate Symptom Score (IPSS) Questionnaire

How Severe Are Your Symptoms ?




Not at all
Less than 1 time in 5
Less than half the time
About half the time
More than half the time
Almost always


Not at all
Less than 1 time in 5
Less than half the time
About half the time
More than half the time
Almost always


Not at all
Less than 1 time in 5
Less than half the time
About half the time
More than half the time
Almost always


Not at all
Less than 1 time in 5
Less than half the time
About half the time
More than half the time
Almost always


Not at all
Less than 1 time in 5
Less than half the time
About half the time
More than half the time
Almost always


Not at all
Less than 1 time in 5
Less than half the time
About half the time
More than half the time
Almost always


None
1 time
2 times
3 times
4 times
5 or more times


Delighted
Pleased
Mostly Satisfied
Mixed
Mostly Dissatisfied
Unhappy
Terrible

Total Score: 0
Symptom Category: