In Past Month have you had the under mentioned symptoms ? Have you felt like your bladder is not completely empty after urination in the past month ? None (0 points) Less than once every 5 times (1 point) Less than once every 2 times (2 points) About once every 2 times (3 points) More than once every 2 times (4 points) Almost always (5 points) Have you had to go to the toilet within 2 hours of doing so in the past month ? None (0 points) Less than once every 5 times (1 point) Less than once every 2 times (2 points) About once every 2 times (3 points) More than once every 2 times (4 points) Almost always (5 points) Have you had disrupted urination in the past month? None (0 points) Less than once every 5 times (1 point) Less than once every 2 times (2 points) About once every 2 times (3 points) More than once every 2 times (4 points) Almost always (5 points) Have you found it hard to control urine in the past month ? None (0 points) Less than once every 5 times (1 point) Less than once every 2 times (2 points) About once every 2 times (3 points) More than once every 2 times (4 points) Almost always (5 points) Have you had a case of weak urination in the past month ? None (0 points) Less than once every 5 times (1 point) Less than once every 2 times (2 points) About once every 2 times (3 points) More than once every 2 times (4 points) Almost always (5 points) Have you had to strain to initiate urination in the past month ? None (0 points) Less than once every 5 times (1 point) Less than once every 2 times (2 points) About once every 2 times (3 points) More than once every 2 times (4 points) Almost always (5 points) How many times do you on the average get up to urinate at night after going to bed in the past month ? None (0 points) Once (1 point) Twice (2 points) 3 Times (3 points) 4 Times (4 points) 5 times or more (5 points)