Georgia Prostate - PAE Quiz

Prostate Symptom Score - Quality Of Life Questionnaire
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MonthDayYear
The following questions ask about your feelings and experiences regarding the impact of prostate symptoms on your life. Please consider each question as it relates to your experiences with prostate symptoms during the previous 1 month. There are no right or wrong answers. Please be sure to answer every question by checking the most appropriate box. If the question does not apply to you, please check “none of the time” as your option.
1. Over the past month, how often have you had a sensation of not emptying your bladder completely after you finished urinating?*

Not at allLess than 1 time in 5Less than half the timeAbout half the timeMore than half the timeAlmost Always
2. Over the past month, how often have you had to urinate again less than 2 hours after you finished urinating?*

Not at allLess than 1 time in 5Less than half the timeAbout half the timeMore than half the timeAlmost Always
3. Over the past month, how often have you found you stopped and started again several times when you urinated?*

Not at allLess than 1 time in 5Less than half the timeAbout half the timeMore than half the timeAlmost Always
4. Over the past month, how often have you found it difficult to postpone urination?*

Not at allLess than 1 time in 5Less than half the timeAbout half the timeMore than half the timeAlmost Always
5. Over the past month, how often have you had a weak urinary stream?*

Not at allLess than 1 time in 5Less than half the timeAbout half the timeMore than half the timeAlmost Always
6. Over the past month, how often have you had to push or strain to begin urination?*

Not at allLess than 1 time in 5Less than half the timeAbout half the timeMore than half the timeAlmost Always
7. Over the past month, how many times did you most typically get up to urinate from the time you went to bed at night until the time you got up in the morning?*

Not at allLess than 1 time in 5Less than half the timeAbout half the timeMore than half the timeAlmost Always
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