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American Urological Association Symptom Index

Topic Overview

The American Urological Association (AUA) has developed the following questionnaire to help men determine how bothersome their urinary symptoms are and to check how effective their treatment is.footnote 1 This questionnaire has also been adopted worldwide and is known as the International Prostate Symptom Score (IPSS). It is sometimes seen with a Quality of Life Scale at the end of the questionnaire.

Symptom score point scale

Use the following point scale to answer the questions.

  • 0 points means you answered "never" to the question.
  • 1 point means you answered "less than 1 out of 5 times" to the question.
  • 2 points means you answered "less than half of the time" to the question.
  • 3 points means you answered "about half of the time" to the question.
  • 4 points means you answered "more than half of the time" to the question.
  • 5 points means you answered "almost always" to the question.

Symptom score questions

  1. Over the past month, how often have you had the feeling of not completely emptying your bladder after you finished urinating?
  2. Over the past month, how often have you had to urinate again less than 2 hours after you finished urinating?
  3. Over the past month, how often have you found that you stopped and started again several times when you urinated?
  4. Over the past month, how often have you found it hard to hold your urine?
  5. Over the past month, how often have you had a weak urine stream?
  6. Over the past month, how often have you had to push or strain to begin urination?
  7. Over the past month, have you had to get up to urinate during the night? Give a score to the number of times.
    • 0 means you did not get up at all.
    • 1 means you got up 1 time.
    • 2 means you got up 2 times.
    • 3 means you got up 3 times.
    • 4 means you got up 4 times.
    • 5 means you got up 5 times or more.

For example, for question number 1, a man who had the feeling of not completely emptying his bladder less than half the time (but more than 1 out of 5 times) would get 2 points for that question. For question number 4, a man who found it hard to hold his urine less than once out of every 5 times would get 1 point for that question.

Symptom score total

Total your score.

Your score shows how severe your symptoms are. This symptom index may be used to develop a treatment plan. Your doctor may also ask you to take the test again after treatment to see how well treatment helped your symptoms.

Compare your total score to the list below.

Score and severity of problem



0 to 7


8 to 19


20 to 35


Quality of life

If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that?

  • Delighted
  • Pleased
  • Mostly satisfied
  • Mixed
  • Mostly dissatisfied
  • Unhappy
  • Terrible



  1. Barry MJ, et al. (1992). American Urological Association symptom index for benign prostatic hyperplasia. Journal of Urology, 148(5): 1549–1557.


Current as of: February 11, 2020

Author: Healthwise Staff
Medical Review: E. Gregory Thompson, MD - Internal Medicine
Adam Husney, MD - Family Medicine
J. Curtis Nickel, MD, FRCSC - Urology

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