This calculator is for general information and education. It is not medical advice and does not replace the judgment of a doctor, nurse or pharmacist who knows the full clinical picture.
Measuring urinary symptoms
Many men over 50 notice changes in how they urinate: a weaker stream, waking at night to urinate, or a feeling of not emptying fully. These lower urinary tract symptoms often come from benign prostatic hyperplasia, a non-cancerous enlargement of the prostate. The International Prostate Symptom Score turns these complaints into a number, so a man and his doctor can judge their severity and follow changes over time.
The questionnaire
Seven questions cover the past month, each scored from 0 (not at all) to 5 (almost always):
- Incomplete emptying
- Frequency, needing to urinate again within 2 hours
- Intermittency, the stream stopping and starting
- Urgency, difficulty postponing urination
- Weak stream
- Straining to start
- Nocturia, the number of times you get up at night to urinate (0 to 5 or more)
An eighth question asks how you would feel if you had to live with your symptoms as they are, from 0 (delighted) to 6 (terrible).
Interpretation
| Total score | Severity |
|---|---|
| 0 to 7 | Mild |
| 8 to 19 | Moderate |
| 20 to 35 | Severe |
The calculator also splits the score into voiding symptoms (incomplete emptying, intermittency, weak stream, straining) and storage symptoms (frequency, urgency, nocturia). Storage symptoms that dominate can point to an overactive bladder rather than an obstruction.
Example
A man who answers 2, 2, 1, 1, 2 and 1 to the first six questions and gets up twice a night:
- Total: 11 out of 35, moderate symptoms
- Voiding subscore: 6, storage subscore: 5
- Quality of life: 3, mixed feelings
What the score is for
- Deciding whether treatment is worthwhile: men with mild symptoms that do not bother them often choose watchful waiting with lifestyle changes, such as drinking less in the evening and limiting caffeine and alcohol.
- Following the effect of medication, such as alpha-blockers or 5-alpha-reductase inhibitors, or of surgery.
- A drop of about 3 points is the smallest change most men notice.
When to see a doctor
The score does not diagnose the cause. See a doctor for any new urinary symptoms, and promptly for blood in the urine, pain, fever, inability to urinate or symptoms that get worse quickly. The doctor may examine the prostate, test the urine and kidney function and discuss PSA testing.