Male Urinary Tract (IPSS)

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

Please view our information leaflet about Urinary Tract Infections.

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

Over the past month, how often does your bladder not feel empty when finished passing urine? *
Over the past month, how often do you need to pass urine within 2 hours of last urinating? *
Over the past month, how often does the flow stop and start when passing urine? *
Over the past month, how often is it hard to delay passing urine? *
Over the past month, how often is the flow poor? *
Over the past month, how often do you need to push or strain to begin? *
Over the past month, how often do you need to pass urine after going to bed? *
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? *
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