NIH Chronic Prostatitis Symptom Index (NIH-CPSI)

• in the area between the rectum and testicles (perineum)?

• in the testicles?

• in the tip of the penis (not related to urination)?

• below the waist, in the pubic or bladder area?

• during urination?

• during or after sexual climax (ejaculation)?

What has been the AVERAGE pain over the last 2 weeks? (enter 0 for no pain, up to 10 for unimaginable agony)

How often have you had pain or discomfort in any of these areas?

How often have you had a sensation of not emptying your bladder completely after you finished urinating?

How often have you had to urinate again less than 2 hours after you finished urinating?

How much have your symptoms kept you from doing the kinds of things you would usually do?

How much did you think about your symptoms, over the last week?

How would you feel if you had to spend the rest of your life with the same level of symptoms as during the last week?