Prostate symptom score (IPSS): answer 7 questions on urinary symptoms in the past month for a score out of 35 – mild, moderate or severe – and next steps.
The International Prostate Symptom Score (IPSS) is a short questionnaire that doctors use to rate urinary symptoms, the kind that often come with an enlarged prostate (benign prostatic hyperplasia, or BPH). Its seven symptom questions are the American Urological Association (AUA) Symptom Index, published by Barry and colleagues in 1992, and the IPSS adds a single quality-of-life question. Each symptom question is scored from 0 to 5 according to how often it happened over the past month, so totals run from 0 to 35.
Total score
Symptoms
0–7
Mild
8–19
Moderate
20–35
Severe
The quality-of-life answer runs from 0 (delighted) to 6 (terrible). It is reported on its own and is not added to the total. Doctors look at it together with the score when deciding whether symptoms are bothersome enough to treat.
What your score can and cannot tell you
It shows how much urinary symptoms bother you. It does not show what is causing them.
The same symptoms can come from an overactive bladder, a urine infection, diabetes, some medicines or, less often, prostate cancer. A high score is a reason to see a doctor, not a diagnosis.
A low score does not rule out prostate cancer, which often causes no symptoms early on. Ask your doctor whether a PSA blood test is right for you.
Taking the questionnaire again after a change in treatment or habits helps you and your doctor see whether things are improving.
Simple habits that may ease symptoms
Cut down on caffeine and alcohol, especially in the evening.
Drink less in the last couple of hours before bed, but do not cut your total fluids for the day.
Try “double voiding”: wait a moment after you finish, then try to go again.
A total of 0–7 counts as mild. Scores of 8–19 are moderate and 20–35 are severe. How much the symptoms bother you, shown by the quality-of-life answer, matters as well.
Does a high IPSS score mean I have prostate cancer?
No. The score rates how much urinary symptoms affect you. Most of these symptoms come from benign prostate enlargement or bladder problems rather than cancer. A doctor can examine you and arrange tests to find the cause.
Is the quality-of-life question part of the score?
No. It is scored separately from 0 (delighted) to 6 (terrible) and helps your doctor understand how much the symptoms affect your daily life.
How often should I repeat the IPSS?
There is no fixed rule. Your doctor may ask you to repeat it at follow-up visits, for example after starting or changing treatment, to see whether your symptoms have changed.
Checked against the sources listed above. This is general health information and not medical advice — please ask your doctor or a registered dietitian what suits you.