Have you undergone any of the following treatments on your prostate: Surgical removal of the prostate for cancer, transurethral resection of the prostate (TURP) or brachytherapy (seed treatment)?
Yes
No
Do you ever experience unplanned, sudden urine loss either while sleeping
or during the day?
Yes
No
Do you experience leakage while laughing, sneezing, jumping or performing
other movements that put pressure on the bladder?
Yes
No
Do you have trouble holding urine as you hurry to the bathroom?
Yes
No
Do you frequently experience a sudden and immediate urge to urinate?
Yes
No
Have you noticed a change in your frequency of urination?
Yes
No
Do you visit the bathroom to urinate more than 8 times per day?
Yes
No
Do you currently wear pads or liners to protect against unplanned leaks?
Yes
No
When planning a trip, outing, or event, does the availability or location of
restroom facilities affect your decision?
Yes
No
If you answered “Yes” to 2 or more of these questions, you should know that there are solutions available for you. Please print this quiz and take it with you when you meet with your urologist to discuss your individual situation.
