PDO IT YOURSELF TESTS

Frequency/volume chart

Please complete this chart for upto 7 random days
Use a jug to measure the amount of urine that you pass (please measure in mls) and enter the amount in
a box at the appropriate time. If you are unable to measure the volume (e.g. if you are at work) then put
a tick in the box instead.

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IIQ-7
Incontinence Impact Questionnaire– (IIQ-7)

The questions below refer to areas in your life that may have been influenced or changed by your
problem.
For each question, circle the response that best describes how much your activities, relationships,
and feelings are being affected by urine leakage.

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UROGENITAL DISTRESS INVENTORY (UDI 6)
Do you experience it?
If so how find out how much are you bothered by it.

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IPSS International Prostate Symptom
Score (IPSS)

Please answer the following questions about your urinary symptoms. Write your score for each question at the end of each row.

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