Are Bladder Control Issues Impacting Your Life?

To rate your symptoms, print out this page and circle the number for each question that is closest to what you have recently experienced. When you have finished the survey, add up the points to find out your score. The possible total ranges from 0 to 32 points, with higher scores indicating more severe symptoms. Print out and bring this symptom score to your next doctor visit.

Have you ever felt like you can't control your bladder like you used to?	0	1	2	3	4
Do you wake up at night having to use the bathroom?	0	1	2	3	4
Do you sometimes have to push or strain to urinate?	0	1	2	3	4
Do you feel like you have to urinate all the time or urinate more than seven times each day?	0	1	2	3	4
Do you find yourself staying near bathrooms or wearing absorbent undergarments because you sometimes leak urine?	0	1	2	3	4
Are there activities you no longer enjoy because of bladder control issues?	0	1	2	3	4
Do you turn down invitations from friends or family because you're afraid you'll experience incontinence?	0	1	2	3	4
Do bladder control issues occupy your thoughts?	0	1	2	3	4
Total

While men frequently suffer similar symptoms from an enlarged prostate (Benign Prostatic Hyperplasia or BPH), this therapy is not intended for patients with BPH. Overactive bladder (OAB) and BPH are not the same disease. Talk to your doctor to learn more about your symptoms and possible treatments.
Learn more about BPH.

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• About Overactive Bladder

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