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International Prostate Symptom Score (IPSS)

American Urological Association (AUA) Symptom Index

International Prostate Symptom Score (I-PSS)
The International Prostate Symptom Score (IPSS) consists of 8 questions (the original  American Urological Association symptom score (AUA-7)) plus one additional quality of life question that is listed below.  This screening tool  is the most commonly used assessment tool for men with lower urinary tract symptoms (LUTS) and can be used to rapidly diagnose and track the symptoms of benign prostatic hyperplasia (BPH).  

The 7 symptoms questions include:
1. Incomplete emptying
2. Frequency
3. Intermittency
4. Urgency
5. Weak Stream
6. Straining
7. Nocturia

The score for each question varies from 0 to 5 depending on the response selected, and the maximum total score is 35 for all 7 questions.
Interpretation:
Score:
1-7:  Mild urinary symptoms
8-19:  Moderate urinary symptoms
20-35: Severe urinary symptoms

This test can be repeated multiple times in order to track the impact of various treatment interventions.  A lower score at a later date can show that treatment goals are being met or the patient is progressing as anticipated. Frequently, this test is conducted at the same time as the IIEF/SHIM screening because of the commonly seen comorbidity of lower urinary tract symptoms and erectile dysfunction.


Instructions:
The following questions refer to selected urinary tract symptoms that may have existed during the past 4 weeks.   Please select the choice that best describes each symptom.   Also, every question must be answered. 
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?
 
1. Incomplete Emptying
How often have you had the sensation of not emptying your bladder?
Not at All
Less than 1 in 5 Times  (<20%)
Less than Half the Time
About Half the Time
More than Half the Time
Almost Always
2. Frequency
How often have you had to urinate less than every two hours?
Not at All
Less than 1 in 5 Times  (<20%)
Less than Half the Time
About Half the Time
More than Half the Time
Almost Always
3. Intermittency
How often have you found you stopped and started again several times when you urinated?
Not at All
Less than 1 in 5 Times  (<20%)
Less than Half the Time
About Half the Time
More than Half the Time
Almost Always
4. Urgency
How often have you found it difficult to postpone urination?
Not at All
Less than 1 in 5 Times  (<20%)
Less than Half the Time
About Half the Time
More than Half the Time
Almost Always
5. Weak Stream
How often have you had a weak urinary stream?
Not at All
Less than 1 in 5 Times  (<20%)
Less than Half the Time
About Half the Time
More than Half the Time
Almost Always
6. Straining
How often have you had to?
Not at All
Less than 1 in 5 Times (<20%)
Less than Half the Time (<50%)
About Half the Time
More than Half the Time
Almost Always
7. Nocturia
How many times did you typically get up at night to urinate?
None   
1 Time
2 Times
3 Times
4 Times
5 Times

References
Barry MJ, Fowler FJ Jr, O'Leary MP,et. al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992 Nov;148(5):1549-57.
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