Complete this survey to help us assess your enlarged prostate symptoms. As men age, the prostate gland continues to grow. By age 50, many men experience symptoms of an enlarged prostate, including difficulty urinating, frequent urination, pain or pressure in the bladder, and getting up repeatedly at night to urinate. This is often due to an enlarged prostate, also called benign prostate hyperplasia (BPH). The answers you give to the survey below can help ARA experts determine if you might be a candidate for prostate artery embolization (PAE), a non-surgical way to shrink the prostate that can also avoid the dysfunction and side effects that standard prostate surgery can cause. Fill out and submit the following survey and an ARA interventional coordinator will contact you to determine if prostate artery embolization is right for you. "*" indicates required fields FacebookThis field is for validation purposes and should be left unchanged.American Urological Association Symptom ScoreNot at AllLess than 1 time in 5Less than half the timeAbout half the timeMore than half the timeAlmost AlwaysOver the past month, how often have you had a sensation of not emptying your bladder completely after you finished urinating?Over the past month, how often have you had to urinate again less than 2 hours after you finished urinating?Over the past month, how often have you stopped and started again several times when you urinated?Over the past month, how often have you found it difficult to postpone urination?Over the past month, how often have you had a weak urinary stream?Over the past month, how often have you had to push or strain to begin urination?Over the past month, how many times did you most typically get up to urinate from the time you went to bed at night until the time you got up in the morning? (Check the column which best represents the number of times you awake each night, on average.)ScoreInterpreting Your Test Score0-7 Points: Enlarged Prostate Symptoms, also known as BPH Symptoms, are considered mild. 8-19 Points: Enlarged Prostate Symptoms, also known as BPH Symptoms, are considered moderate. 20-35 Points: Enlarged Prostate Symptoms, also known as BPH Symptoms, are considered severe. This index is a guide for determining the severity of your symptoms and is only one step in diagnosing enlarged prostate. Regardless of the prostate test score, if you are experiencing BPH symptoms that interfere with your quality of life, you may wish to see a physician for further evaluation and information regarding this condition.Next Steps for Prostate Health0 to 12 points: With symptoms in this range, you should visit your primary care provider for an assessment of your prostate health. They may prescribe medication or lifestyle changes that decrease the symptoms of BPH. 13 to 35 points: Your symptoms are likely at the point where they are interfering with your quality of life. Prostate artery embolization may be the right procedure to treat your symptoms, with fewer side effects and less sexual dysfunction than prostate surgery. Please submit your scores and our team will contact you. Submit your scores to ARA Diagnostic ImagingConsent to Submit ScoreIF YOUR SCORE IS 13 OR ABOVE YOU MAY BENEFIT FROM PAE. IF IT IS 12 OR BELOW, YOU SHOULD VISIT YOUR PRIMARY CARE PHYSICIAN. If you scored 13 or more, please enter the information below to submit your scores to us and we will follow up with you about your next steps. Yes, I consent to submit my scores Name* First Last Age*Date of birth*MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Email* Phone*Are you currently taking medication for BPH (enlarged prostate)?* Yes No How long have you been on the medication?* less than 3 months more than 3 months What is the name of the medication(s) you are taking?*Other than medication, what other treatments or procedures have you had for BPH?*