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He past 4 weeks. Please place a or in the box that best describes the extent to which you were bothered by each symptom during the past 4 weeks. There are no right or wrong answers. Please be sure to answer every question. During the past 4 weeks, how bothered were you by. . . 1. An uncomfortable urge to urinate? 2. A sudden urge to urinate with little or no warning? 3. Accidental loss of small amounts of urine? 4. Nighttime urination? 5. Waking up at night because you had to urinate? 6. Urine.

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