This is a really important test!
Please do take the time to think about these questions and fill them in.
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Question 1 of 6
Do you leak urine?
Or have you leaked urine during the last 4 weeks?
Yes
No
Question 2 of 6
Have you had ANY leakage from your back passage (anus) even just wind in the last 4 weeks?
Question 3 of 6
Any of the following concerns regarding having sex:
Lack of labido and interest?
Difficulty to get or maintain a functional erection?
Premature ejaculation?
Leaking of urine or faeces during or after sexual intercourse?
Question 4 of 6
None of the above but I am just wanting to make sure my pelvic floor and core are in good shape for my future.
YES
Question 5 of 6
Are you about to have treatment or surgery for Prostate Cancer?
Question 6 of 6
Are you about to have surgery or have just had surgery to remove or reduce your Prostate?