Urinary Function Assessments

SubjectID

Date

YYYY

Assessment

1. Incomplete Emptying How often have you had the sensation of not emptying your bladder?

0- Not at all 1- Less than 1 in 5 2- Less than Half the Time 3- About Half the Times 4- More than Half the Time 5- Almost Always

2. Frequency How often have you had to urinate less than every two hours?

0- Not at all 1- Less than 1 in 5 2- Less than Half the Time 3- About Half the Times 4- More than Half the Time 5- Almost Always

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

0- Not at all 1- Less than 1 in 5 2- Less than Half the Time 3- About Half the Times 4- More than Half the Time 5- Almost Always

4. Urgency How often have you found it difficult to postpone urination?

0- Not at all 1- Less than 1 in 5 2- Less than Half the Time 3- About Half the Times 4- More than Half the Time 5- Almost Always

5. Weak Stream How often have you had a weak urinary stream?

0- Not at all 1- Less than 1 in 5 2- Less than Half the Time 3- About Half the Times 4- More than Half the Time 5- Almost Always

6. Straining How often have you had to strain to start urination

0- Not at all 1- Less than 1 in 5 2- Less than Half the Time 3- About Half the Times 4- More than Half the Time 5- Almost Always

7. Nocturia How many times did you typically get up at night to urinate?

Indicate 5 - If 5 times or more

QOL - 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- Delighted 1- Pleased 2- Mostly Satisfied 3- Mixed 4- Mostly Dissatisfied 5- Unhappy 6- Terrible

MaxFlow

cc/s

AveFlow

cc/s

PVR

PressMaxFlow

Voiding pressure @ MaxFlow