г. Краснодар ул. 40 лет Победы, 108
ул. Яна Полуяна, 51

ул. 40 лет Победы, 108
ул. Яна Полуяна, 51

Наши специалисты

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Врачи отделения

Смотрите также:
Посетитель сайта из г. Краснодар только что записался на прием

Анкета пациента
Опросник для оценки синдрома болезненного мочевого пузыря
Аналоговая шкала оценки симптомов синдрома болезненного мочевого пузыря / интерстициального цистита
0 — симптом не беспокоит 10 — симптомы крайне выражены («все настолько плохо, насколько возможно»)
0 — не влияют 10 — экстремально влияют на качество жизни («все настолько плохо, насколько возможно»)
Опросник для диагностики интерстициального цистита
Сколько раз Вы посещаете туалет во время бодрствования?
3-6
7-10
11-14
15-19
20+
Сколько раз Вы посещаете туалет во время сна?
0
1
3
4
5
Насколько мешает вам ночное мочеиспускание?
Не мешает
Немного
Умеренно
Сильно
Если у Вас сохранена сексуальная жизнь, испытываете ли Вы боль или частые позывы на мочеиспускание во время или после полового акта?
Никогда
Иногда
Часто
Всегда
Заставляет ли Вас боль или частые позывы на мочеиспускание избегать сексуальной активности?
Никогда
Иногда
Часто
Всегда
Есть ли у Вас боль в области мочевого пузыря или малом тазу (низ живота, влагалище, уретра, промежность)?
Никогда
Иногда
Часто
Всегда
Оцените интенсивность боли (если есть):
Незначи-
тельная
Умерен-
ная
Сильная
Как часто боль беспокоит Вас?
Никогда
Иногда
Часто
Всегда
Есть ли у Вас внезапные позывы к мочеиспусканию вскоре после мочеиспускания?
Никогда
Иногда
Часто
Всегда
Оцените интенсивность внезапных позывов к мочеиспусканию:
Незначи-тельная
Умерен-ная
Сильная
Как часто внезапные позывы беспокоят Вас?
Никогда
Иногда
Часто
Всегда