Transcription of BPH Symptom Index Questionnaire Augusta …
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BPH Symptom Index Questionnaire Augusta …
BPH Symptom Index Questionnaire Augusta Urology Associates, LLC. Patient Name: _____ DOB: _____ ID: _____. Less than More than Less than 1 About 1/2 Almost Not at all 1/2 the 1/2 the time in 5 the time always time time Over the last month or so, how often have you had a sensation of not emptying your 0 1 2 3 4 5. bladder completely after you finished urinating? During the last month or so, how often have you had to urinate again less than two hours 0 1 2 3 4 5. after you finished urinating? During the last month or so, how often have you stopped and started again several times 0 1 2 3 4 5. when you urinated? During the last month or so, how often have 0 1 2 3 4 5. you found it difficult to postpone urination? During the last month or so, how often have 0 1 2 3 4 5. you had a weak urinary stream?
Augusta Urology Associates, LLC Patient ID: _____ Date Time Amount Voided Asleep? Voiding Diary
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