盆腔四重造影在出口梗阻性便秘诊断中的作用和意义

目的研究出口梗阻性便秘(OOC)患者盆底形态变化和盆腔脏器间的相互关系。方法对59例经物理检查初步诊断为OOC的患者和12例正常自愿者行排粪造影,结合盆底、膀胱造影,女性阴道放置浸钡标记物(四重造影)检查,测量肛直角、会阴位置、盆底腹膜位置、膀胱位置。结果在59例OCC患者中,经盆腔四重造影诊断直肠内脱垂46例,盆底腹膜疝29例,直肠前突7例,盆底肌痉挛综合征7例,会阴下降综合征5例;还发现膀胱脱垂6例,子宫后倾或脱垂10例。与正常自愿者相比,OOC组力排相肛直角明显增大(P<0.05),静息相和力排相会阴异常下降(P<0.05,P<0.01),力排相盆底腹膜位置下降非常显著(P<0.01)。OOC组中伴泌尿系症状者静息相和力排相膀胱位置均显著低于正常自愿者(P<0.05,P<0.01)。结论盆腔四重造影可有效诊断直肠内脱垂和直肠前突;对临床症状隐匿、物理检查难以诊断的盆底腹膜疝以及膀胱、子宫脱垂提供了诊断依据;有助于选择正确合理的治疗方法。     

Reliability of an osteoporosis-targeted quality of life survey instrument for use in the community: OPTQoL

A brief Osteoporosis-Targeted Quality of Life (OPTQoL) questionnaire was previously developed as a cross-sectional survey instrument to assess the community impact of osteoporosis on quality of life in women. The initial development process involving item generation through focus groups, item reduction, and content and construct validation yielded a 36-item questionnaire with three domains (physical difficulty, adaptations and fears) and 10 health-related questions. In the present study, test-retest reliability and internal consistency of the questionnaire were assessed in a mail-based study with two clinical sites. Two hundred women (50 with severe osteoporosis, 50 with osteopenia, 50 with normal bone mineral density (BMD) and 50 with osteoarthritis and normal BMD), aged 43–84 years, completed the self-administered questionnaire initially and again about 2 weeks later. Using weighted kappas, agreement between questionnaire administrations ranged from 0.60 to 0.80 for most of the individual items. Intraclass correlation coefficients to assess reliability for the domain scores were 0.93 (physical difficulty), 0.82 (adaptations) and 0.88 (fears). Internal consistency of each of the domains was also high, with Cronbach’s alpha coefficients ranging from 0.89 to 0.91. Four items were dropped from the 36-item questionnaire due to high percentage of ‘not applicable’ responses. Results of the analyses support the validity and reliability of this instrument as a cross-sectional survey tool for assessing the impact of osteoporosis on quality of life in women living in the community. The questionnaire has been translated and culturally adapted into seven languages to allow cross-cultural studies of the community impact of osteoporosis.     

Interaction of filling related sensation between anorectum and lower urinary tract and its impact on the sequence of their evacuation. A study in healthy volunteers

AIMS: The anorectum and lower urinary tract (LUT) are closely related organs: anorectal and LUT dysfunction often occur concomitant, and therapeutic actions in one organ may influence function of the other. The aim of this study was to explore the physiologic relationship between anorectal and LUT function in healthy volunteers. METHODS: Two groups of healthy volunteers were studied. Anorectal and LUT sensory function was evaluated in ten volunteers during rectal balloon and bladder filling. The second group of 100 volunteers reported on defecation and micturition during five toilet visits. They graded perception on rectal and bladder fullness on a visual analogue scale and marked which organ evacuation started first. RESULTS: The volumes at which the different sensations of rectal filling during balloon distension were perceived was significantly higher with full bladder than with empty bladder (P<0.04). Five hundred toilet visits were described. Although mean perception grade of rectal fullness was significantly higher than for bladder fullness (P<0.0001), defecation started only in 36% of the reported visits before micturition. Only when the rectum was considered completely full, or the bladder completely empty, defecation occurred more frequently before micturition. In all other cases, micturition more frequently occurred before defecation. CONCLUSIONS: When the bladder is full, sensation of rectal filling is decreased. When healthy people visit the toilet to defecate, the initiation of micturition often precedes that of defecation, even if both organs are considered equally full.     

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目的 研究出口梗阻性便秘（OCC）病人盆腔器官及盆底形态结构变化及其临床意义。方法 对38例OOC病人及12位健康自愿者（对照组）行空，阴道，膀胱及排粪同步造影（以下简称“四重造影”），测量肛直角，会阴位置，盆底腹膜位置，膀胱位置。结果 四重造影诊断直肠内脱垂直37例，直肠前突5例，盆底痉挛综合征5例。四重造影检查还发现盆底及腹膜疝9例，膀胱脱出6例，会阴下降综合征3例，子宫后倾或脱垂10例。与对照组相比，OOC组力排相肛直角增大，静息相及力排相会阴异常下降，力排相Douglas陷凹加深；OOC组中有泌尿系统症状者，静息相及力排相膀胱异常下降。结论 四重造影诊断直肠内脱垂和直肠前突的阳性率较高，而且对临床隐匿，物理检查难以诊断的盆底及腹膜疝，膀胱及子宫异常，阴道脱出等疾病提供了形象客观的诊断依据，提高了诊断的性，有助于选择正确合理的治疗方式。     

Videomanometry of the pelvic organs: A comparison of the normal lower urinary and gastrointestinal tracts

BACKGROUND: Both the lower urinary tract (LUT) and the caudal part of the lower gastrointestinal tract (LGIT) are innervated by the sacral spinal cord. We aimed to compare the normal physiology of the LUT and LGIT using the same videomanometry method. METHODS: We recruited fifteen healthy volunteers (eight men and seven women; mean age, 60 years). The videomanometric measures included fluoroscopic images, subtracted bladder/rectal pressures, urethral/anal sphincter pressures, sphincter electromyography, and urinary/fecal flow. RESULTS: During the resting phase, the urethral/anal sphincter pressures showed almost the same values (mean, 70 cmH2O and 68 cmH2O, respectively). During the storage phase, the volumes at first sensation and maximum capacity for the LGIT (129 mL and 320 mL) were slightly smaller than those for the LUT (170 mL and 405 mL). Compliance of the LGIT (65 mL/cmH2O) was almost as high as that of the LUT (99 mL/cmH2O). However, the LGIT showed spontaneous phasic rectal contractions (SPRC) that were never seen in the bladder. None of the subjects experienced leakage during bladder/rectal filling. During the evacuation phase, rectal contraction on defecation (14 cmH2O) was present, but was weaker than bladder contraction on micturition (42 cmH2O; P < 0.01). Abdominal strain on defecation (70 cmH2O) was greater than that on micturition (25 cmH2O; P < 0.01). Sphincter pressure increase on defecation (13 cmH2O) was greater than that on micturition (-52 cmH2O). An illustrative case of SPRC that were seen during urodynamic recording was shown. CONCLUSION: SPRC and abdominal strain are features of the LGIT, whereas micturition bladder contraction is a feature of the LUT. These features can aid in understanding the possible rectal 'artifacts' of videourodynamics and neurogenic pelvic organ dysfunction.     

Validation of the Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7) in a Dutch population

Introduction and hypothesis

The objective of this study was to validate the Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7) in Dutch women.

Methods

Patients with pelvic floor dysfunction completed the Dutch questionnaires at (1) inclusion to evaluate internal consistency, (2) 1 week later to assess test-retest reliability, and (3) 6 months later to assess responsiveness and interpretability of change. To assess validity, floor and ceiling effects and construct validity were tested. A population-based sample (reference group) completed the questionnaires once.

Results

Data of 111 patients and 283 reference group participants were analyzed. Internal consistency of baseline scores in patient and reference groups was moderate (Cronbach’s alpha 0.52–0.60) to adequate in the PFDI-20 (Cronbach’s alpha 0.71–0.84) and adequate in the PFIQ-7 (Cronbach’s alpha 0.88–0.94). Both measures presented adequate test-retest reliability (intraclass correlation coefficient 0.79–0.91) and adequate responsiveness (area under the receiver-operating characteristic curve both 0.77). Interpretability was adequate for PFDI-20 and acceptable for PFIQ-7 with a clinically relevant minimally important change of ?23 and ?29 points, respectively. At baseline, the scales of the PFIQ-7 showed floor effects (44–55 %) in patients, though the PFIQ-7 summary score did not. No ceiling effects were observed. Construct validity was adequate with all predefined hypotheses confirmed regarding subgroup discrimination using pooled patient and reference group baseline data.

Conclusions

For assessing distress and health-related quality of life of pelvic floor dysfunction, the Dutch PFDI-20 and PFIQ-7 are reliable and valid in the general Dutch population, and also responsive and interpretable among tertiary care-seeking women.     

Pelvic floor dysfunction is not a risk factor for febrile urinary tract infection in adults

Study Type – Therapy (case control)
Level of Evidence 3b

OBJECTIVE

To determine whether pelvic floor dysfunction (PFD) might be a risk factor for or consequence of febrile urinary tract infection (UTI), as UTI in adults is a common infection in which an underlying urological abnormality is often considered, and as in children, PFD is also thought to have a pathophysiological role in adults with UTI.

PATIENTS AND METHODS

A multicentre case‐control study was conducted at 26 primary‐care centres and at six Emergency Departments of regional hospitals. Cases were consecutive patients aged ≥18 years, who presented with febrile UTI. Controls were randomly selected subjects who visited their general practitioner for reasons other than UTI or fever. A validated pelvic floor questionnaire (the Pelvic Floor Inventories Leiden, PelFIs) was used to assess pelvic floor function.

RESULTS

Between October 2006 and December 2007, 153 cases were included; of these, the completed questionnaires of 102 (response rate 67%) were compared to those of 100 of 110 (response rate 91%) controls. The median age of cases and controls was 65 and 58 years, respectively; 40% of cases and controls were men. The percentage of PelFIs outcomes consistent with PFD were comparable between cases and controls, at 21% vs 23%, respectively (odds ratio 0.9, 95% confidence interval, CI, 0.4–1.78). In the multivariate analysis, comorbidity (odds ratio 4.9, 95% CI 2.2–11.1) and a history of UTI (odds ratio 2.5, 95% CI 1.0–6.1) were independent significant risk factors for febrile UTI, whereas PFD was not (odds ratio 1.0, 0.5–2.2). Within the group of cases, PFD was not associated with bacteriuria during assessment of PelFIs (odds ratio 1.1, 95% CI 0.4–3.5) and inversely related to a history of UTI within the previous year (odds ratio 0.2, 0.1–0.9).

CONCLUSIONS

PFD is common among adults but it does not seem to be a risk factor for febrile UTI.     

Measuring health-related quality of life in women with urogenital dysfunction: the urogenital distress inventory and incontinence impact questionnaire revisited

AIMS: Symptoms of urogenital dysfunction are known to negatively affect health-related quality of life in women. To assess effectiveness of treatment, it is currently recommended to include measurements of quality of life in outcome analysis. One of the questionnaires that is commonly used is the combination of the Urogenital Distress Inventory (UDI) and Incontinence Impact Questionnaire (IIQ). Unfortunately, the validity of the UDI and IIQ has only been tested in highly selected subgroups of female patients. Therefore, it is unclear whether this questionnaire is suitable for use in populations with different characteristics. METHODS: We analyzed the scale construction and validity of the UDI and IIQ in a random sample of 2,042 women, aged 20-70 years old and a clinical sample of 196 women. RESULTS: Our results show that the UDI can be divided into five subscales, namely discomfort/pain, urinary incontinence, overactive bladder, genital prolapse, and obstructive micturition. The internal consistency (Cronbach's alpha) ranged between 0.74 and 0.82. In addition to the original four subscales of the IIQ (mobility, physical, social, and emotional functioning), we identified a fifth subscale with four items about embarrassment. Internal consistency of these subscales ranged between 0.83 and 0.93. In addition to the internal consistency, we tested the criterion and construct validity of these new subscale division. CONCLUSIONS: We found these subscales to be reliable and of clinical use. It is recommended to use the revised UDI and IIQ in outcome analysis of treatments for urogenital symptoms in women.     

Validación de la versión en español del cuestionario “Epidemiology of Prolapse and Incontinence Questionnaire-EPIQ”

IntroductionOne out of three women suffers from pelvic floor disorders. Thus, an instrument to evaluate this pathology in common clinical practice would be very useful. In this study the psychometric characteristics of the Spanish version of the US questionnaire “Epidemiology of Prolapse and Incontinence Questionnaire-EPIQ” have been evaluated, in order to test its equivalence to the original and allow for its use in Spain.Material and Methods60 women with pelvic floor pathology and 60 control women filled in the Spanish version of the EPIQ. The questionnaire was validated following the statistical procedure used in the validation of the original form.Results: Factibility113 women filled in all questionnaire items and 7 leaved some of them blank. Validity: 7 dimensions were indentified: quality of life (QoL), overactive bladder (OAB), anal incontinence (AI), micturition difficulty/pain (MD/P), functional defecation disorders (FDD), stress urinary incontinence (SUI), and pelvic organ prolapse (POP). The validity of contents was proved comparing the mean scores for each dimension in patients and control (T-student test). Positive and negative predictive values were POP=92,3% and 82,52%; SUI= 54,34% and 84,93%; OAB=60,6% and 84,52% and AI=24,32% and 92,68%. Reliability: Global Cronbach´s-alfa was 0,94 and for the different dimensions: 0,96 (QoL); 0,91 (OAB); 0,63 (AI); 0,72 (MD/P); 0,75 (FDD) y 0,61 (SUI).DiscussionThe Spanish version of the EPIQ questionnaire presents adequate factibility, validity and reliability to evaluate pelvic floor pathology in clinical practice.     

出口梗阻性便秘病人的盆腔、阴道、膀胱及排粪同步造影

目的：研究出口梗阻性便秘（Outlet Obstructive Constipation,OOC)病人盆腔器官及盆底形态结构变化。方法：对38例出口梗阻性便秘病人及12例正常对照者行盆腔、阴道、膀胱及排粪同步造影（以下简称“四重造影”）,包括盆腔造影,阴道涂以钡剂,结合排尿膀胱造影和排粪造影。测量肛直角、会阴位置、盆底腹膜位置、膀胱位置。结果：四重造影诊断直肠内脱垂37例,直肠前突5例,盆底痉挛综合征5例,而物理检查拟诊断分别为12例,4例,1例,均100％得到造影检查证实。四重造影检查还发现盆底及腹膜疝9例,膀胱脱出6例,会阴下降综合征3例,子宫后倒或脱垂10例。与对照组相比,OOC组和排相肛直角增大,静息相及力排相会阴异常下降,力排相Douglas陷凹加深;OOC组中有泌尿系症状者,静息相及力排相膀胱异常下降。结论：四重造影诊断直肠内脱垂和直肠前突的阳性率明显高于临床物理诊断;而且对临床隐匿、物理检查难以诊断的盆底及腹膜疝、膀胱及子宫、阴道脱出等提供了形象客观的诊断依据,提高了诊断的准确性,有助于选择正确合理的手术方式。     

A comparison of patient and partner responses to a brief sexual function questionnaire

PURPOSE: Patient self-administered questionnaires have recently been developed to assess sexual function in men with erectile dysfunction. However, it may also be important to assess satisfaction with and any improvements in sexual function from the perspective of the female partner. We report the results of a brief 3-item questionnaire developed for the female partner and its association with an 11-item questionnaire developed for men with erectile dysfunction. MATERIALS AND METHODS: Men and their female partners each self-administered a brief sexual function questionnaire several times during a clinical trial of an experimental treatment for erectile dysfunction. Items addressed the frequency and firmness of erection, and satisfaction with sex life on a 5-point Likert scale with responses ranging from 0 to 4. We compared mean values of the 3 items common to each questionnaire by respondent, and also analyzed item and scale correlations using weighted kappa statistics and/or the Pearson correlation coefficient. RESULTS: Data from 389 pairs were available. Generally patient results were fairly consistent with those of partners. Men reported slightly more frequent erection (1.6 versus 1.5), identical firmness of erection (1.2) and less satisfaction (1.2 versus 1.4) than partners. Weighted kappas of the 3 items ranged from 0.47 to 0.61, representing good agreement. The Pearson correlations were slightly higher. Internal consistency reliability using Cronbach's alpha of the 3-item scale was 0.69 (0.77 for patient and 0.81 for partner). CONCLUSIONS: These data support the use of patient and partner assessments of sexual function in clinical trials of erectile dysfunction.     

Epidemiology of prolapse and incontinence questionnaire: validation of a new epidemiologic survey

The epidemiology of prolapse and incontinence questionnaire (EPIQ) was developed to screen for female pelvic floor disorders (PFD). Content and face validity, reliability, internal consistency and criterion validity of the EPIQ to detect the presence of pelvic organ prolapse (POP), stress urinary incontinence (SUI), overactive bladder (OAB) and anal incontinence (AI) is presented. Cronbach's alpha; Spearman's, kappa, intraclass correlations, factor analysis and Chi-Squared tests were used for analysis. Questions related to PFD proved internally consistent (alpha = 0.91) and reproducible (correlations >0.70) for all but three items on the EPIQ. Positive and negative predictive values of the EPIQ to detect PFD were: POP = 76% and 97%, SUI = 88% and 87%, OAB = 77% and 90% and AI = 61% and 91% respectively. EPIQ is a psychometrically validated screening instrument that may identify women at high risk of having pelvic floor disorders in large undiagnosed populations.     

Défécographie chez des volontaires sains: résultats et implications

Forty-seven healthy young volunteers underwent defecographic examination to determine the range of normal findings. Normality was shown to encompass radiological features often considered pathological. These features included broad ranges of anorectal angle and pelvic floor descent which overlap with reported pathological states. Furthermore, the formation of rectocoeles during defecation was a very common finding in women. Finally, a subgroup of the volunteers had marginal anorectal function. The marginal anorectal function and certain radiological findings such as rectocoeles or intussusceptions may predispose to later problems, or contribute to clinical problems when combined with other factors such as dietary fibre deficiency. The radiological findings raise a number of questions with respect to different aspects of the functioning of the continence and defecation mechanisms.     

Reliability, validity, and gender differences in the quality of life index of the SEAPI-QMM incontinence classification system

PURPOSE: To evaluate reliability and validity of the SEAPI-QMM 15-item quality of life index and assess differences between male and female patients with urinary incontinence. MATERIALS AND METHODS: Twice pre- and once post-treatment, 315 patients (102 men, 213 women) with incontinence and 35 without incontinence completed the self-directed SEAPI-QMM quality of life index. A voiding diary reported frequency of incontinence episodes with number of pads or type of protection used daily for incontinence. In 30%, the Nottingham Health Profile (NHP) was administered to further validate the measure. RESULTS: Cronbach's alpha coefficient for the index was 0.91. Domain-specific alpha coefficients ranged from 0.88 to 0.73. Test-retest reliability scores at 5 days gave a reliability coefficient of 0.93. Split half reliability was 0.89. Correlation of the index with the NHP was 0.78 for women, 0.72 for men. Mean scores before and after treatment with medical or surgical management were significantly different in both genders and were sensitive to the presence or absence of use of protection and the type of protection chosen in men. Men with incontinence (61%) reported a high level of impact in the sexuality domain compared to 7% of women. CONCLUSIONS: The SEAPI quality of life index has a high degree of reliability relating to stability and internal consistency across a wide age range in both genders. There are differences between men and women in life domains most frequently affected by urinary incontinence.     

Posterior vaginal compartment prolapse and defecatory dysfunction: are they related?

While posterior vaginal compartment prolapse and defecatory dysfunction are highly prevalent conditions in women with pelvic floor disorders, the relationship between anatomy and symptoms, specifically obstructed defecation, is incompletely understood. This review discusses the anatomy of the posterior vaginal compartment and definitions of defecatory dysfunction and obstructed defecation. A clinically useful classification system for defecatory dysfunction is highlighted. Available tools for the measurement of symptoms, physical findings, and imaging in women with posterior compartment prolapse are discussed. Based on a critical review of the literature, we investigate and summarize whether posterior compartment anatomy correlates with function. Definitions of obstructed defecation and significant posterior compartment prolapse are proposed for future exploration.     

Australian pelvic floor questionnaire: a validated interviewer-administered pelvic floor questionnaire for routine clinic and research

The aim of this study was to design and validate an interviewer-administered pelvic floor questionnaire that integrates bladder, bowel and sexual function, pelvic organ prolapse, severity, bothersomeness and condition-specific quality of life. Validation testing of the questionnaire was performed using data from 106 urogynaecological patients and a separately sampled community cohort of 49 women. Missing data did not exceed 2% for any question. It distinguished community and urogynaecological populations regarding pelvic floor dysfunction. The bladder domain correlated with the short version of the Urogenital Distress Inventory, bowel function with an established bowel questionnaire and prolapse symptoms with the International Continence Society prolapse quantification. Sexual function assessment reflected scores on the McCoy Female Sexuality Questionnaire. Cronbach’s α coefficients were acceptable in all domains. Kappa coefficients of agreement for the test–retest analyses varied from 0.5 to 1.0. The interviewer-administered pelvic floor questionnaire assessed pelvic floor function in a reproducible and valid fashion in a typical urogynaecological clinic. The validation of the interviewer-administered pelvic floor questionnaire was presented at the Annual Meeting of the International Continence Society in 2004, Paris (podium presentation; extended abstract): A validated female pelvic floor questionnaire for clinicians and researchers, Baessler K, O’Neill S, Maher C, Battistutta D, Neurourol Urodynam 2004; 23: 398–399.     

Measurement properties of the Dutch version of the Western Ontario Shoulder Instability Index (WOSI)

Background

The Western Ontario Shoulder Instability Index (WOSI) is a disease-specific shoulder questionnaire to measure quality of life in patients with shoulder instability. The aim of the present study was to translate the WOSI into Dutch and assess its principal measurement properties.

Methods

The WOSI was translated into Dutch according to guidelines in the literature. Fifty-two shoulder instability patients completed the questionnaire twice within 2 weeks. We assessed internal consistency (Cronbach’s alpha), test–retest reliability [Intraclass Correlation Coefficient (ICC)], standard error of measurement (SEM), smallest detectable change (SDC) and reliable change index. The Bland–Altman analysis was applied to assess test–retest agreement and floor and ceiling effects were calculated.

Results

Cronbach’s alpha was 0.95 for the total WOSI score (range 0.88–0.95 for the 4 domains). ICC for the total WOSI score was 0.91 (range 0.79–0.90 for domains), SEM was 130.6 for the total WOSI score resulting in a SDC of 362.0, which is 17.3 % of the maximum obtainable score of 2100. Bland–Altman analysis showed no systematic differences or consistent bias between the two assessments. We observed no relevant floor and ceiling effects.

Conclusion

The results of the present study suggest the Dutch version of the WOSI is a reliable tool for clinical assessment and scientific evaluation. It shows high values for Cronbach’s alpha and ICC implying excellent internal consistency and good test–retest reliability.     

The Integral Theory System Questionnaire: an anatomically directed questionnaire to determine pelvic floor dysfunctions in women

Purpose

Anatomical damage to pelvic floor structures may cause multiple symptoms. The Integral Theory System Questionnaire (ITSQ) is a holistic questionnaire that uses symptoms to help locate damage in specific connective tissue structures as a guide to reconstructive surgery. It is based on the integral theory, which states that pelvic floor symptoms and prolapse are both caused by lax suspensory ligaments. The aim of the present study was to psychometrically validate the ITSQ.

Materials and methods

Established psychometric properties including validity, reliability, and responsiveness were considered for evaluation. Criterion validity was assessed in a cohort of 110 women with pelvic floor dysfunctions by analyzing the correlation of questionnaire responses with objective clinical data. Test–retest was performed with questionnaires from 47 patients. Cronbach’s alpha and “split-half” reliability coefficients were calculated for inner consistency analysis.

Results

Psychometric properties of ITSQ were comparable to the ones of previously validated Pelvic Floor Questionnaires. Face validity and content validity were approved by an expert group of the International Collaboration of Pelvic Floor surgeons. Convergent validity assessed using Bayesian method was at least as accurate as the expert assessment of anatomical defects. Objective data measurement in patients demonstrated significant correlations with ITSQ domains fulfilling criterion validity. Internal consistency values ranked from 0.85 to 0.89 in different scenarios.

Conclusions

The ITSQ proofed accurate and is able to serve as a holistic Pelvic Floor Questionnaire directing symptoms to site-specific pelvic floor reconstructive surgery.     

Translation and linguistic validation of the Persian version of the Bristol Female Lower Urinary Tract Symptoms instrument

Introduction and hypothesis

The aim of this study was to evaluate the psychometric properties of the Persian version of the International Consultation on Incontinence Modular Questionnaire for Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) in patients with urinary tract dysfunction.

Methods

After gaining permission from the International Consultation on Incontinence Modular Questionnaire (ICIQ) advisory board, the English Female Lower Urinary Tract Symptoms (FLUTS) questionnaire was translated into Persian and then translated back into English. One hundred fourteen women with pelvic floor dysfunction were asked to complete the Persian FLUTS and International Consultation on Incontinence Modular Questionnaire Overactive Bladder Questionnaire (ICIQ-OAB). The Persian FLUTS questionnaire was also readministered to 20 patients 2 weeks after their initial visit. Study data were analyzed using SPSS V16.0. To validate the translated questionnaire, we assayed content/face validity, internal consistency/reliability, and construct validity. Internal consistency and test–retest reliability were assessed using Cronbach’s alpha and the intraclass correlation coefficient (ICC) respectively.

Results

The mean age of the patients was 48.8 years old, 84% were married, and 59% had at least one Caesarean. Except for very few missing data, there is no any ambiguity in the Persian version of the FLUTS questionnaire. The Cronbach’s alpha was 0.83, indicating a high internal consistency. Concerning criterion validity, correlation between the Persian FLUTS and the OAB was 0.77 (p?<?0.001).

Conclusion

The initial testing of the Persian version of the FLUTS questionnaire demonstrates good internal consistency, content validity, and reliability.