Incontinence QuizI leak urine when I cough, sneeze, laugh or lift something heavy.(Required) Never Rarely Sometimes Often AlwaysI feel sudden, strong urges to urinate that are hard to control.(Required) Never Rarely Sometimes Often AlwaysI sometimes do not make it to the bathroom in time.(Required) Never Rarely Sometimes Often AlwaysI leak urine during physical activity (exercise, sports, walking, etc.)(Required) Never Rarely Sometimes Often AlwaysI wake up at night to urinate more than once.(Required) Never Rarely Sometimes Often AlwaysI feel that my bladder does not completely empty after using the restroom.(Required) Never Rarely Sometimes Often AlwaysI have difficulty starting or maintaining a urine stream.(Required) Never Rarely Sometimes Often AlwaysI avoid certain activities (exercise, social events, travel) because of bladder and bowel concerns.(Required) Never Rarely Sometimes Often AlwaysI avoid drinking fluids because I worry about leaking.(Required) Never Rarely Sometimes Often AlwaysI use pads, liners, or protective garments because of leakage.(Required) Never Rarely Sometimes Often AlwaysI feel embarrassed or anxious about my bladder control.(Required) Never Rarely Sometimes Often AlwaysI feel urgency with bowel movements that’s hard to manage.(Required) Never Rarely Sometimes Often AlwaysI feel heaviness, bulging, or pressure in my pelvic area.(Required) Never Rarely Sometimes Often AlwaysI plan my day around knowing where bathrooms are located.(Required) Never Rarely Sometimes Often AlwaysBladder problems interfere with my overall quality of life.(Required) Never Rarely Sometimes Often Always
