NorthShore Bladder Health Quiz

1. Are you Male or Female?

Male

Female

2. Do you have a sudden need to rush to the toilet to urinate?

Never

Sometimes

Often

Always

3. Do you sometimes not make it to the bathroom on time?

Never

Sometimes

Often

Always

4. How often do you urinate during the day?

1-6 times

7-8 times

9-10 times

11 or more times

5. Do you get up 2 or more times throughout the night to urinate?

Never

Sometimes

Often

Always

6. Do you experience a loss of urine when exercising?

Never

Sometimes

Often

Always

7. Do you experience a loss of urine when you cough or sneeze?

Never

Sometimes

Often

Always

8. Do you experience a loss of bowel control?

Never

Sometimes

Often

Always

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