Gastrointestinal/Genitourinary
  1. Bladder control problems?
  2. Have you had any urinary problems?
  3. Any pain on urination and/or blood in your urine?
  4. Do you need to get up in the night to urinate?
  5. Any pain on urination?
  6. Any difficulty starting your urine stream?
  7. Any decreased force of your urine stream?
  8. Any increase or decrease in the number of times you urinate per day?
  9. Any impotence?
  10. Any history of bladder infection, kidney infection, prostate swelling, or kidney stones?
  11. What are your normal bowel habits? Any changes in those bowel habits?
  12. Any abdominal bleeding?
  13. Any abdominal discomfort, pain, or cramps?
  14. Any constipation or diarrhea, dark stools, or blood in your stools?
  15. Any heartburn or indigestion?
  16. Any rectal bleeding, discharge, or pain?
  17. Any difficulties holding your urine or feces?
  18. Any nausea or vomiting?