1 out of 5
Have you ever had any bladder "accidents"?
2 out of 5
Has any bladder medication that you have taken caused you to have constipation, dry eyes, abnormally dry mouth, or other side effects?
3 out of 5
Do you frequently need to use the restroom at a moment's notice?
Clarification*frequently = multiple times daily
4 out of 5
How would you feel if you were to spend the rest of your life in your current urological condition?
ClarificationAre your activities limited by how close a bathroom is?
5 out of 5
Last month, how often did you have a weak urinary stream?
ClarificationIs your sleep interrupted by these bathroom trips?