Symptoms	Never	Rarely	Sometimes	Often	Usually	Always
Over the past week or so, how often have you had a painful or burning feeling during urination?	0	1	2	3	4	5
Over the past week or so, how often have you had discomfort in the pubic or bladder area?	0	1	2	3	4	5
Over the past week or so, how often have you had pain or discomfort during or after ejaculation?	0	1	2	3	4	5
Over the past week or so, how often have you had pain or discomfort in the testicles?	0	1	2	3	4	5
Over the past week or so, how often have you had pain or discomfort in the penis?	0	1	2	3	4	5
Over the past week or so, how often have you had pain or discomfort in the area between the testicles and anus (perineum)?	0	1	2	3	4	5
Over the past week or so, how often have you felt that you are not emptying your bladder completely after urinating?	0	1	2	3	4	5
Over the past week or so, how often have you had yourself urinating too often?	0	1	2	3	4	5
Over the past week or so, about how many times do you urinate from the time you get up in the morning until the time you go to bed at night? (✓)	1 to 3 times a day	4 to 5 times a day	6 to 7 times a day	8 to 9 times a day	10 to 11 times a day	12 or more times a day
Over the past week or so, about 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? (✓)	None	1 time	2 times	3 times	4 times	5 or more times