International Prostate Symptom Score (IPSS)

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Today I’m going to show you a well-constructed questionnaire in prostate disease symptom assessment or IPSS International Prostate Symptom Score. Prostate disease is a common medical condition for gentlemen who were more than 50 years of age. This medical condition really affects their quality of life. Urologist must do the entire essential stuff such as history record, physical examine and another proper investigations.

Name of patient	______________________________________
Date of doing the questionaire	______________________________________
Date of birth	______________________________________

International Prostate Symptom Score questions will ask you about the urinary symptom over the last four weeks. Please try to answer each question honestly and clearly as much as you can.

International prostate symptom score (IPSS)

1. INCOMPLETE EMPTYING.  How often have you had sense of inability emptying your bladder? (Choose one answer below)

a.            Not at all

b.            Feeling bad like less than 20%

c.            Feeling bad like less than 50%

d.            Feel bad about  50%

e.            More than 50% felt bad

f.            Almost always terrible/Always terrible

2. FREQUENCY. How many times you need to urinate by less than 2 hours? (Choose one answer below)

a.            Not at all

b.            Feeling bad like less than 20%

c.            Feeling bad like less than 50%

d.            Feel bad about  50%

e.            More than 50% felt bad

f.            Almost always terrible/Always terrible

3. INTERMITTENCY. How often have you gone on and off several times during urinating? (Choose one answer below)

a.            Not at all

b.            Feeling bad like less than 20%

c.            Feeling bad like less than 50%

d.            Feel bad about  50%

e.            More than 50% felt bad

f.            Almost always terrible/Always terrible

4. URGENCY. How often have you felt difficult to hold urination? (Choose one answer below)

a.            Not at all

b.            Feeling bad like less than 20%

c.            Feeling bad like less than 50%

d.            Feel bad about  50%

e.            More than 50% felt bad

f.            Almost always terrible/Always terrible

5. WEAK STREAM. How often have you had a weak stream during urinating? (Choose one answer below)

a.            Not at all

b.            Feeling bad like less than 20%

c.            Feeling bad like less than 50%

d.            Feel bad about  50%

e.            More than 50% felt bad

f.            Almost always terrible/Always terrible

6. STRAINING. How often have you had to push during urination? (Choose one answer below)

a.            Not at all

b.            Feeling bad like less than 20%

c.            Feeling bad like less than 50%

d.            Feel bad about  50%

e.            More than 50% felt bad

f.            Almost always terrible/Always terrible

7. NOCTURIA. How many times do you typically get up to urinate? (Choose one answer below)

a.            None

b.            1 time

c.            2 times

d.            3 times

e.            4 times

f.            5 times

After complete all 7 questions then we can calculate International Prostate Symptom Score (IPSS) which divided into 3 severity categories

• 1 – 7 : Mild symptom
• 8 – 19 : Moderate symptom
• 20 – 35 : Severe symptom

International Prostate Symptom Score (IPSS)	______________________________________

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?

a.	Delightful
b.	Pleasing
c.	More satisfying
d.	Indescribable
e.	Dissatisfying
f.	Unhappy
g.	Terrible

This is all of International prostate symptom score (IPSS). You can visit my official homepage here.