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Urinary Tract (LUTS) Review

If you have been advised by the surgery to submit Urinary Tract (LUTS) Review review please use this form.

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How often does your bladder not feel empty when finished passing urine?
Almost always
More than half the time
About half the time
Less than half the time
Less than 1 in 5 times
None

How often do you need to pass urine within 2 hours of last urinating?
Almost always
More than half the time
About half the time
Less than half the time
Less than 1 in 5 times
None

How often does the flow stop and start when passing urine?
Almost always
More than half the time
About half the time
Less than half the time
Less than 1 in 5 times
None

How often is it hard to delay passing urine?
Almost always
More than half the time
About half the time
Less than half the time
Less than 1 in 5 times
None

How often is the flow poor?
Almost always
More than half the time
About half the time
Less than half the time
Less than 1 in 5 times
None

How often do you need to push or strain to begin?
Almost always
More than half the time
About half the time
Less than half the time
Less than 1 in 5 times
None

How often do you need to pass urine after going to bed?
More than 4
4
3
2
1
None

I confirm that the information provided is accurate to the best of my knowledge.

I confirm that I am currently within the UK at the time of sending my enquiry.