1. Name and Surname:

2. How many times have you had the sensation of not emptying your bladder completely after you finished urinating?

3. How many times have you had to urinate again in the next two hours after you have urinated?

4. How many times have you noticed that when you urinate, he stopped and started again several times?

5. How many times have you had difficulty to hold back the urge to urinate?

6.  How many times has noted that the stream of urine is little strong?

7.  How many times have you had to squeeze or strain to begin urination?

8. How many times do you usually have to get up to urinate from the time you go to bed for the night until you wake up in the morning?

9. How would you feel if you had to spend the rest of your life with prostatic symptoms such as you have now?

10. Comments