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International Prostate Symptom Score (IPSS) Form

    I-PSS Assessment Form



    Question

    0
    Not at all

    1
    < 1 in 5

    2
    < Half

    3
    Half

    4
    > Half

    5
    Almost Always

    1. Incomplete Emptying

    Over the past month, how often have you felt your bladder was not fully empty?

    0

    1

    2

    3

    4

    5

    2. Frequency

    Over the past month, how often have you urinated again in less than 2 hours?

    0

    1

    2

    3

    4

    5

    3. Intermittency

    Over the past month, how often have you stopped and started urinating?

    0

    1

    2

    3

    4

    5

    4. Urgency

    Over the past month, how often was it difficult to postpone urination?

    0

    1

    2

    3

    4

    5

    5. Weak Stream

    Over the past month, how often have you had a weak urinary stream?

    0

    1

    2

    3

    4

    5

    6. Straining

    Over the past month, how often have you had to strain to begin urination?

    0

    1

    2

    3

    4

    5

    7. Nocturia

    Over the past month, how many times do you typically wake at night to urinate?

    0

    1

    2

    3

    4

    5

    Quality of Life due to
    Urinary Symptoms

    0
    Delighted

    1
    Pleased

    2
    Mostly Satisfied

    3
    Mixed

    4
    Mostly Unhappy

    5
    Unhappy

    6
    Terrible

    0

    1

    2

    3

    4

    5

    6

    The I-PSS is based on the answers to seven questions concerning urinary symptoms. Each question is assigned points from 0 to 5 indicating increasing severity of the particular symptom. The total score can therefore range from 0 to 35 (asymptomatic to very symptomatic).

    Although there are presently no standard recommendations into grading patients with mild, moderate or severe symptoms, patients can be tentatively classified as follows: 0 – 7 = mildly symptomatic; 8 – 19 = moderately symptomatic; 20 – 35 = severely symptomatic.

    The International Consensus Committee (ICC) recommends the use of only a single question to assess the patient’s quality of life.
    The answers to this question range from “delighted” to “terrible” or 0 to 6. Although this single question may or may not capture the global impact of BPH symptoms on quality of life, it may serve as a valuable starting point for doctor-patient conversation.

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