QUESTIONNAIRE OF THE QUALITY OF LIFE
1. I worry if I wet myself because of urinary loss.
2. I worry if I lose urine when I cough or sneeze.
3. I have to be careful to get up because of urine loss
4. I always must know where the bathroom is when I go to new places.
5. I feel depressed because I lose urine.
6. Because I lose urine I worry, and do not leave my house for long periods of time.
7. I feel frustrated because the urine loss stops me from doing what I would like to do.
8. I worry that others might feel the smell of urine on me.
9. The fact that I lose urine is always in my head.
10.I always have to go to the bathroom.
11. Because of urine loss I must plan things before hand and in detail.
12. I worry that the urine loss will get worse as I get older.
13. I do not sleep well because of urine loss.
14. I am afraid to be embarrassed or humiliated because of urine loss.
15. Urine loss makes me feel that I am not healthy.
16. Urine loss makes me feel hopeless.
17. I feel that I do not take more advantage from life because of urine loss.
18. I am worried that I will not make it to the bathroom.
19. I feel like I have lost control of my bladder.
20. I must be careful with the amount of liquids that I drink because of urine loss.
21. Urine loss limits the way I dress.
22. I am worried with urine loss during sex.
1 = very frequently
2 = moderately
3 = not much
4 = it is not applied