Genitourinary History |
Yes / No |
| Number of times that you urinate at night? |
0-1 |
| Number of times that you urinate during the day? |
5 |
| Any trouble starting the urine stream? |
N |
| Any trouble stopping the urine stream? |
N |
| Any pain with urination? |
N |
| Any difficulty holding urine? |
N |
| Any back pain related to urination? |
N |
| Ever had blood in urine? |
N |
| Ever had puffiness of face or eyes? |
N |