Enlarged Prostate Survey

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.

* Required

	Not at All	Less than 1 time in 5	Less than half the time	About half the time	More than half the time	Almost Always
Over 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.)

Complete this survey to help us assess your enlarged prostate symptoms.

0-7 Points

8-19 Points

20-35 Points

Is It Time For Your Mammogram?

Enlarged Prostate Survey

Complete this survey to help us assess your enlarged prostate symptoms.

Interpreting Your Test Score

0-7 Points

8-19 Points

20-35 Points

Is It Time For Your Mammogram?