When the questionnaire is completed, tally up each score for your total aua score. It is used for men who are having problems that are likely to be related to an enlarged prostate. Over the past month, how often have you had a sensation of not. Simply click the most accurate answer for each question.
Add the score for each number above and write the total in the space to the right. American urological association symptom index to assess severity of benign prostatic hyperplasia bph. Canadian urological association guideline on male lower. The american urological association aua has developed the following questionnaire to help men determine how bothersome their urinary symptoms are and to check how effective their treatment is.
Your score indicates the severity of your symptoms. Aua symptom survey not at all less than 1 time in 5 half the time about half the time more than half the time almost always over the past month, how often have you had a sensation of not emptying your bladder completely after you. The questions refer to the following urinary symptoms. Ahcpr recommended guidelines for treatment patients with mild bph sx aua score aua symptom score. To calculate your voiding symptom severity, make a response by clicking on one response box for each of the 7 questions below.
A simple tool for assessment of benign prostatic hyperplasia in rural setting article pdf available in indian journal of community health 252. The questionnaire assesses degree of luts and quality of life. Adam questionnaire about symptoms of low testosterone. It is sometimes seen with a quality of life scale at the. Having to urinate more frequently, as well as more urgently, can definitely interrupt. To complete this selftest, circle one number on each line. The international prostate symptom score ipss is an eightquestion written screening tool used to screen for, rapidly diagnose, track the symptoms of, and suggest management of the symptoms of benign prostatic hyperplasia bph it contains seven questions related to symptoms related to bph and one question related to the patients perceived quality of life. American urological association aua bph symptom score index. Benign prostatic hyperplasia bph is one of the most common disease in ageing men and can be associated with lower. Total aua symptom score add above column totals together the disease specific quality of life question 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. The international prostate symptom score ipss previously the aua symptom score calculator determines a patients risk of developing prostate disease based on the evidence presented in this questionnaire. Sexual health inventory for men shim instructions each question has 5 possible responses. American urological association bph symptom score index.
Your total score is calculated after you click the submit button, and you can use it to help determineread more. The international prostate symptom score ipss questionnaire was developed to measure the severity of your bph symptoms. Dob date circle one number on each line not at all less than 1 time in 5 lessthan half the time about half the time more than half the time almost always over the past month or so, how often have you had a sensation of not. If you were to spend the rest of your life with your urinary condition just. You should know that frequent urination is often a symptom of benign prostatic hyperplasia bph, a noncancerous enlargement of the prostate gland. Highlight or bold or change font color of the response correct for you and type in your score in the far right box for all seven questions. Delighted 0 pleased 1 mostly satisfied 2 mixed 3 mostly disappointed 4 unhappy 5 terrible 6. Calculator searchfilter keywords at the calculator level, ecalcs comes delivered with default keywords that can be leveraged in the searchfilter field to enable specialty or system driven. Typical presenting symptoms include urinary hesitancy, weak stream. Your score is not meant to provide medical advice or replace your doctors expert opinion and care. Only your doctor can diagnose whether you have bph and assess your individual condition. The international prostate symptom score ipss is a common method for screening and diagnosing benign prostatic hyperplasia bph. Circle the correct answer for you and write your score in the righthand column.
Tm laser therapy aua symptom score questionnaire the american urological association aua has created this symptom index to give you and your physician an understanding of the severity of your enlarged prostate symptoms. Have you noticed any of the following when you have gone to the bathroom to urinate over the past month. Download our aua symptom score pdf and take the brief selfquiz to evaluate the severity of your symptoms. American urological association symptom index cigna. Score nocturia i get up to urinate after i go to bed until the time i get up in the morning. The aua symptom score calculator determines a patients risk of developing prostate disease based on the evidence presented in the questionnaire. The american urological association symptom index for benign prostatic hyperplasia.
Over the past month, how often have you had the sensation of not emptying. You should know that frequent urination is often a symptom ot benign prostatic hyperplasia bph, a noncancerous enlargement of the prostate gland. American urological association symptom score please answer the following questions relating to the last month or so. During the past month or so, how often have you had to urinate again less than. It is helpful in determining which treatment option is best. Shim total score 2225 no ed, 1721 mild, 1216 mild to moderate, 811 moderate, and 17 severe ed title microsoft word bug aua symptom score sheet. American urological association aua bph symptom score. Circle the correct answer for you and write your score. Circle one number on each line not at all less than. Diagnosis and management of benign prostatic hyperplasia. A score of 0 to 7 indicates mild bph, 8 to 19 moderate bph, and 20 to 35 severe bph. Please circle the best response that pertains to each of the seven questions listed below and list your score next to each question.
The first seven questions of the ipss are identical to the questions appearing on the american. Symptom score severity 0 to 7 mild, 8 to 19 moderate, 20 to 35 severe. Adam questionnaire about symptoms of low testosterone androgen deficiency in the aging male this basic questionnaire can be very useful for men to describe the kind and severity of their low testosterone symptoms. Download the aua symptom score pdf and take a brief selfquiz to evaluate the severity of your symptoms. American urological association bph symptom score index questionnaire having to urinate more frequently. The american urological association aua has developed the following questionnaire to help men determine how bothersome their urinary symptoms are and to.
The possible total runs from 0 to 35 points with higher scores indicating more severe symptoms, scores less than seven are considered mild and generally do not warrant treatment. Incomplete emptying over the past month, how often have you had a sensation of not emptying your bladder. International prostate symptom score ipss what is the ipss score. How do you rate your confidence that you could keep an erection.
Symptom score severity 0 to 7 mild, 8 to 19 moderate, 20 to 35 severe total score. Circle one number on each line not at all less than 1 time in 5 lessthan half the time about half the time more than half the time almost always over the past month or so, how often have you had a sensation of not emptying your bladder completely after. The practice guidelines committee of the aua selected the panel cochairs who in turn appointed the additional panel members with specific expertise in this area. Benign prostatic hyperplasia is a common condition affecting older men. American urological association bph symptom score index questionnaire having to urinate more frequently, as well as more urgently, can definitely interrupt the flow of your day. Circle one number on each line over the past month or so, how often have you had a sensation of not emptying your bladder completely after you finished urinating. Erectile dysfunction ed guideline american urological. American urological association aua bph symptom score index to complete this selftest, circle one number on each line. Take the american urological association symptom score test to see if you may have enlarged prostate or bph.
American urological association urinary symptom score international prostate symptom score ipps for men name. Add the score for each number above, and write the total in the space to the right. Barry, fowler, oleary, 1992, ahcpr clinical practice guidelines on bph, 1994 i. Scores less than 7 are considered mild and do not warrant treatment. Not at all less than 1 in 5 times less than half the time about half the time more than half the time almost always your score 1. The american urological association aua has created this symptom index to give you and your physician an understanding of the severity of your enlarged prostate symptoms. We recommend that you talk with a health care provider if your total score on the first seven questions is 8 or greater or if you are bothered at all. Over the past month, how often have you had a sensation of not emptying your bladder completely.
The first seven questions of the ipss are identical to the questions appearing on the american urological association aua symptom index which currently categorizes symptoms as follows. Add up all the circled numbers to get the total score. Circle the number that best describes your own situation. Aua patient symptom score questionnaire the american urological association aua has created this symptom index to give you and your physician an understanding of the severity of your enlarged prostate symptoms. Circle your answer and record your score in the right column. Bph symptom score questionnaire auass symptom score. The total runs from 0 to 35 points with higher scores indicating more severe symptoms. The total score can therefore range from 0 to 35 asymptomatic to very symptomatic. Mild symptom score less than of equal to 7 moderate symptom score range 819 severe symptom score range 2035.
Over the past month, how often have you had a sensation of not emptying your bladder completely after you finished urinating. Urological association aua symptom index which currently. Common questions about the diagnosis and management of. Aua symptom score auass almost always 5 or more times terrible patient name. Aua symptom score highlight or bold or change font color of the response correct for you and type in your score in the far right box for all seven questions. The aua guideline also advocates watchful waiting for patients with moderate to severe symptoms of bph aua symptom score of eight who are not bothered by. Over the pas t month, how often have you had a sensation of not emptying your. The symptom index may then be used to develop a treatment plan. If you scored 8 points or higher, you should consult your physician. The aua symptom score index, also known as the international prostate symptom score ipss, is a tool doctors use to evaluate and monitor bph.
The ipss questionnaire allows your urologist to better understand the severity of your water work symptoms. How often have you had a sensation of not emptying your bladder completely after you. American urological association bph symptom score index questionnaire. American urological association symptom score auass. American urological association symptom index an overview. Your bph symptom score to check your bph symptoms score, complete the following questions based on your experience over the past month. Over the past month, how often have you found it difficult to postpone urination. The measurement committee of the american urological association. The aua symptom score index bph symptom quiz you can use the following american urological association aua bph symptom score index to evaluate your enlarged prostate symptoms. The international prostate symptom score ipss is a useful subjective assessment tool for bph patients. The male sexual dysfunction panel was created in 20 by the american urological association education and research, inc. This material is provided for information purposes only and is not a substitute.