International Prostate Symptom Score (IPSS)

The IPSS questionnaire allows your GP to better understand the severity of your urinary symptoms. It is used for men who are having problems that are likely to be related to an enlarged prostate. It is helpful in determining which treatment option is best for you and then monitoring any improvement. There are 7 questions relating to different symptoms you might be experiencing and one question relating to your overall quality of life. Once you have scored each question the values are added together to give an indication of the severity of your symptoms.

First Name *

Last Name *

Date Of Birth *

With the following questions, please select the rating that best represents your experience during the last month. Use the scale below to choose the most appropriate repsonse for each situation.

It is important that you answer each question as best you can.

0 = Not at all

1 = Less than 1 in 5 times

2 = Less than half the time

3 = About half of the time

4 = More than half of the time

5 = Almost always

Over the past month - *

012345

Incomplete emptying: How often have you had a sensation of not emptying your bladder completely after you finish urinating?

012345

Frequency: How often have you had to urinate again less than two hours after you finished urinating?

012345

Intermittency: How often have you found you stopped and started again several times when you urinated?

012345

Urgency: How difficult have you found it to postpone urination?

012345

Weak stream: How often have you had a weak urinary stream?

012345

Straining: How often have you had to push or strain to begin urination?

012345

Nocturia: Over the past month, many times did you most typically get up to urinate from the time you went to bed until the time you got up in the morning?

NoneOnceTwice3 times4 times5 or more

TotalTotal score: 0-7 Mildly symptomatic; 8-19 moderately symptomatic; 20-35 severely symptomatic

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

0 - Delighted1 - Pleased2 - Mostly satisfied3 - Mixed4 - Mostly unhappy5 - Terrible

Adapted from Royal Bath Hospital IPSS NHS Foundation trusthttps://www.ruh.nhs.uk/patients/Urology/documents/patient_leaflets/Form_IPSS.pdf accessed 10 April 2021

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