Questionnaires

You will find below a number of questionnaires on various urological issues that might be helpful in documenting the symptoms a patient is experiencing, their severity and effect on their quality of life.

ICIQ-UI Short Form

This is a validated questionnaire designed to document the type, frequency and severity of incontinence in men or women.

Download ICIQ-UI Short Form – PDF (73Kb)

ICIQ-OAB

This is a validated questionnaire designed to outline the severity of symptoms of an overactive bladder – frequency, urgency etc.

Download ICIQ-OAB – PDF (82Kb)

ICIQ-OABqol

This is a validated questionnaire to document the effect an overactive bladder has on a person’s quality of life.

Download ICIQ-OABqol – PDF (108Kb)

ICIQ-MLUTS Long Form

This is a validated questionnaire to document the type, frequency and severity of lower urinary tract symptoms in a man.

Download ICIQ-MLUTS Long Form – PDF (117Kb)

ICIQ-MLUTS

A shorter version of the form.

Download ICIQ-MLUTS – PDF (96Kb)

ICIQ-FLUTS Long Form

This is a validated questionnaire to document the type, frequency and severity of lower urinary tract symptoms in a woman.

Download ICIQ-FLUTS Long Form – PDF (50Kb)

ICIQ-FLUTS

A shorter version of the form.
Download ICIQ-FLUTS – PDF (103Kb)

ICIQ-LUTSqol

This is a validated questionnaire to document the effect lower urinary tract symptoms on a person’s quality of life.

Download ICIQ-LUTSqol – PDF (105Kb)

International Prostate Symptom Score (IPSS)

This is a validated questionnaire to document the type, frequency and severity of lower urinary tract symptoms – it can be used in men or women. It is the most frequently used questionnaire in the assessment of LUTS.

Download International Prostate Symptom Score – PDF (55Kb)

International Index of Erectile Function (IIEF)

International Index of Erectile Function. This is a validated questionnaire to document the type, frequency and severity of sexual symptoms in a man. This questionnaire is probably the most widely used in the assessment of male sexual issues.

Download International Index of Erectile Function – PDF (147Kb)

ICIQ-MLUTSsex

This is a validated questionnaire to document the type, frequency and severity of lower urinary tract symptoms in a man. This questionnaire was developed to be consistent with the other ICI Questionaries.

Download ICIQ-MLUTSsex – PDF (37Kb)