Self-assessment · Takes about two minutes
Score your urinary symptoms using the same seven-question index urologists use.
The International Prostate Symptom Score (IPSS) — also called the AUA Symptom Index — is the validated instrument doctors use to grade how severe lower urinary tract symptoms are, and to measure whether treatment is changing anything. It takes about two minutes, and the number it gives you is the number your doctor will recognise.
The Seven Questions
For each one, think about the past month.
How often have you had the sensation of not emptying your bladder completely after you finish urinating?
How often have you had to urinate again less than two hours after you finished urinating?
How often have you found you stopped and started again several times when you urinated?
How often have you found it difficult to postpone urination?
How often have you had a weak urinary stream?
How often have you had to push or strain to begin urination?
How many times did you most typically get up to urinate between going to bed and getting up in the morning?
Your score appears here as you answer. Nothing is stored or sent.
What the Score Means
Mild
Symptoms are present but generally not disruptive. Watchful waiting and lifestyle adjustments are the usual first step.
Moderate
The range where most men seek help, and where treatment is usually discussed. Worth an appointment.
Severe
Significant impact on daily life. See a doctor rather than self-managing this range.
The Eighth Question
The full instrument includes one more item, scored separately from the total because it measures impact rather than severity: if you had to live the rest of your life with your urinary symptoms exactly as they are now, how would you feel about it? Answers run from delighted to terrible.
It matters because two men with the same score can be affected very differently. If your score is mild but the answer to that question is “unhappy”, that is worth raising with your doctor too.
See a doctor promptly, whatever your score, if you have:
- Blood in the urine
- Complete inability to urinate
- Fever with back or flank pain
- Pain during urination
- Symptoms that have worsened over days rather than months
A high score is not an emergency in itself, but it is a reason to be examined rather than to start experimenting.
What This Score Cannot Tell You
It cannot distinguish between causes. An enlarged prostate is the most common explanation in men over 50, but overactive bladder, urinary infection, poorly controlled diabetes, sleep apnea and evening diuretics all produce similar answers. A doctor separates them with a physical exam, urinalysis, and often a PSA test and a bladder scan.
It is also a snapshot. Its real clinical value is in repetition — scoring yourself again in eight or twelve weeks shows whether anything has actually changed, which is far more useful than how you feel about it on any given morning.
Related reading
Based on the International Prostate Symptom Score (IPSS), derived from the American Urological Association Symptom Index developed by Barry MJ et al., The American Urological Association symptom index for benign prostatic hyperplasia, J Urol 1992;148(5):1549–1557. Provided for education and self-monitoring only; it does not constitute medical advice or a diagnosis. Aleaf Labs is a Health Canada-licensed natural health product company; Complete Prostate Health (NPN 80087894) is licensed to help relieve the urologic symptoms associated with mild to moderate benign prostatic hyperplasia.