[Validation of the Spanish version of the short forms of the Urogenital Distress Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7) in pregnant women]

Translation and validation of Incontinence Impact Questionnaire Short Form in the Urdu language

INTRODUCTION AND HYPOTHESIS

The Incontinence Impact Questionnaire Short Form (IIQ-7 SF) is a self-administered questionnaire that is used to assess the impact of urinary incontinence on the quality of life in women. It is translated into different languages; however, there is currently no official Urdu version of this tool. The main purpose of this study was to translate the IIQ-7 SF into the Urdu language and to find out its validity and reliability in women with urinary incontinence.

METHODS

The IIQ-7 was translated into the Urdu language by following the standardized steps. The original version was translated into Urdu by two translators and the back translation into English was done by an independent translator. A panel of experts reviewed the translations and a final version was drafted. Fifteen women with urinary incontinence were involved in the pilot study. The validity and reliability were then assessed on 70 women with urinary incontinence.

RESULTS

The content validity index (CVI) of each question ranged from 0.91 to 0.94. The convergent validity with UDI-6 was determined by using Spearman's correlation coefficient (r=0.90). Cronbach's α showed the internal consistency, which is 0.87. The test-retest reliability was calculated by the intra-class correlation coefficient, ICC=0.95. The scree plot showed the two components have eigen values greater than 1.

CONCLUSIONS

The Urdu version of the IIQ-7 has shown good validity and reliability in incontinence patients, according to the findings.

Spanish Cross-Cultural Adaptation of the Australian Pelvic Floor Questionnaire

The main objectives of this study were to carry out the translation and cross-cultural adaptation of the Australian Pelvic Floor Questionnaire (APFQ) into Spanish and the evaluation of its psychometric properties of validity and reliability in the Spanish population. The APFQ was translated into Spanish and back-translated into its original language by native speakers; it was verified that there was a semantic similarity. A pilot test was carried out on a group of 10 women. The study sample was made up of 104 subjects. They were asked to fill in the APFQ twice, 15 days apart. Codes were assigned so they could link to the test and retest. The Questionnaire on Pelvic Floor Dysfunctions-short version (PFDI-20) and the Women's Sexual Function Questionnaire (FSM) were also completed. The reliability, criterion and construct validity, and stability were studied. A Cronbach's alpha of 0.795 was obtained from the complete questionnaire. For each dimension, Cronbach's alpha was 0.864 for bladder function; 0.796 for bowel function; 0.851 for prolapse; and 0.418 for sexual function (0.67 with the suppression of item 37). The APFQ shows a significant correlation with PFDI-20 in urinary function (rho: 0.704, p = 0.000), intestinal function (rho: 0.462, p = 0.000), and prolapse symptoms (rho: 0.337, p = 0.000). The test-retest analysis showed high reproducibility. The Spanish version of the APFQ is a reliable and valid tool to assess symptoms and impacts on quality of life due to pelvic floor dysfunctions in the Spanish population. However, a review of some of its items could increase its reliability.

Spanish Questionnaires for the Assessment of Pelvic Floor Dysfunctions in Women: A Systematic Review of the Structural Characteristics and Psychometric Properties

BACKGROUND

Pelvic floor dysfunctions affect a third of the adult female population, including a large number of clinical conditions, which can be evaluated through validated questionnaires that inform us of the status and perception of women both objectively and subjectively. The main objective of this study was to review and explain the topics of the validated questionnaires in Spanish on pelvic floor dysfunctions and to review their psychometric properties.

METHODS

A systematic review was carried out in the PUBMED and WOS databases. The keywords used were in PUBMED: (((((((("Fecal Incontinence" [Mesh]) OR "Urinary Incontinence" [Mesh]) OR "Pelvic Organ Prolapse" [Mesh]) OR "Pelvic Floor Disorders" [Mesh]) OR "Sexual Dysfunction, Physiological" [Mesh]) OR "Pelvic Girdle Pain" [Mesh]) OR "sexual function" [Title/Abstract]) OR "Prolapse" [Title/Abstract]) AND "Surveys and Questionnaires" [Mesh] AND "Validation" [Title/Abstract] combined with the Boolean operators "AND"/"OR". In contrast, in WOS, a segregated search was carried out with each of the terms of pelvic floor dysfunction together with "Validation" and "Surveys and Questionnaires". All articles published up to 19 November 2021 were considered. Methodological quality was assessed with the COSMIN scale.

RESULTS

A total of 687 articles were identified, of which 13 were included. The evaluated questionnaires and the structural characteristics and psychometric properties of each of them were collected.

CONCLUSION

The Spanish versions of the questionnaires show good basic structural and psychometric characteristics for the evaluation of patients with pelvic floor dysfunctions and that they resemble other versions of the same questionnaire published in other languages.

Long-term outcomes of transvaginal mesh (TVM) In patients with pelvic organ prolapse: A 5-year follow-up

OBJECTIVE

The objective of this study was to evaluate the overall outcomes and complication rates of the transvaginal mesh (TVM) placed for the management of pelvic organ prolapse (POP) at 5-years follow up.

STUDY DESIGN

Retrospective cohort study in Urogynecology section in a single center in Argentina. Patients with prolapse stage II or higher were included. Seventy-six patients had TVM surgery for POP and 72 (95%) were available for the 5-year follow-up period.

RESULTS

The cure rate using the combined criteria (leading edge ≤0 according to Pelvic Organ Prolapse Quantification System (POP-Q), no bulge symptoms and no new treatment for prolapse) was 79.2% (57/72) (95% CI 68-88%). Only 5.5% (4/72) (95% CI 1.5-13.6) were re-operated for prolapse recurrence. Mesh exposure occurred in 16.6% of cases (n = 12; 95%CI 8.9-27.3). The incidence of de-novo dyspareunia was 13.3% (2/15) (95%CI 1-40) CONCLUSIONS: We observed that TVM is a durable treatment for prolapse and that adverse events were acceptable without severe complications at 5-year follow-up.

Consequences of maternal morbidity on health-related functioning: a systematic scoping review

OBJECTIVES

To assess the scope of the published literature on the consequences of maternal morbidity on health-related functioning at the global level and identify key substantive findings as well as research and methodological gaps.

METHODS

We searched for articles published between 2005 and 2014 using Medline, Embase, Popline, CINAHL Plus and three regional bibliographic databases in January 2015.

DESIGN

Systematic scoping review PRIMARY OUTCOME: Health-related functioning RESULTS: After screening 17 706 studies, 136 articles were identified for inclusion. While a substantial number of papers have documented mostly negative effects of morbidity on health-related functioning and well-being, the body of evidence is not spread evenly across conditions, domains or geographical regions. Over 60% of the studies focus on indirect conditions such as depression, diabetes and incontinence. Health-related functioning is often assessed by instruments designed for the general population including the 36-item Short Form or disease-specific tools. The functioning domains most frequently documented are physical and mental; studies that examined physical, mental, social, economic and specifically focused on marital, maternal and sexual functioning are rare. Only 16 studies were conducted in Africa.

CONCLUSIONS

Many assessments have not been comprehensive and have paid little attention to important functioning domains for pregnant and postpartum women. The development of a comprehensive instrument specific to maternal health would greatly advance our understanding of burden of ill health associated with maternal morbidity and help set priorities. The lack of attention to consequences on functioning associated with the main direct obstetric complications is of particular concern.

REVIEW REGISTRATION

CRD42015017774.

Validation of the Spanish version of the Urogenital Distress Inventory short form and Incontinence Impact Questionnaire short form for women between the ages of 18 and 65

BACKGROUND AND OBJECTIVE

To analyze the reliability of the Spanish version of the Urogenital Distress Inventory short form (UDI-6) and Incontinence Impact Questionnaire short form (IIQ-7) questionnaires for assessing the presence of urinary incontinence, the degree of impairment and the impact on quality of life for Spanish women between the ages of 18 and 65.

PATIENTS AND METHODS

A total of 150 women were enrolled throughout Spain and were administered the UDI-6 and IIQ-7 questionnaires in 2 registries performed with a 15-day interval. The ICIQ-short form, in its Spanish version, was used as the gold standard.

RESULTS

In the reliability analysis of the UDI-6, an internal consistency of 0.973 and an intraclass correlation of 0.974 were achieved, with a 95% CI between 0.964 and 0.981. For the IIQ-7, the internal consistency was 0.984 and the intraclass correlation was 0.985, with a 95% CI between 0.985 and 0.977. For both questionnaires, the kappa values for each item ranged from 0.717 to 0.876.

CONCLUSIONS

The Spanish version of the UDI-6 and IIQ-7 questionnaires reliably and consistently assess the urogenital symptoms and their impact on the quality of life of Spanish women between 18 and 65 years of age.

Factors associated with treatment-seeking behavior for postpartum urinary incontinence

PURPOSE

To identify the factors associated with treatment-seeking behavior for urinary incontinence (UI) among postpartum women.

DESIGN

This is a cross-sectional study. A total of 142 women with postpartum UI responded a telephone interview between August of 2010 and March of 2011. The association between the treatment-seeking and the predicting variables were measured through odds ratio and 95% confidence interval.

RESULTS

The treatment-seeking percentage was 37.3% and the treatment percentage was 27.5%. The result of multiple logistic regressions indicated that: counseling about UI in pregnancy, postpartum physical exercise, and Spanish nationality predicted 47.8% of the variance in treatment-seeking behavior

CONCLUSIONS

The lack of counseling largely determines the low rates of treatment-seeking among Spanish mothers.

CLINICAL RELEVANCE

Nursing counseling during pregnancy can contribute substantially to increasing the number of women treated for postpartum UI.

The incontinence impact questionnaire-7 (IIQ-7) can be applicable to Chinese males and females with lower urinary tract symptoms

AIM AND OBJECTIVES

The aim of this study was to extend the scope of application of the Incontinence Impact Questionnaire-7 (IIQ-7) with the objective of assessing the applicability, validity, reliability and sensitivity of the IIQ-7 in both Chinese males and females with lower urinary tract symptoms (LUTS).

METHODS

The validity, reliability and sensitivity were assessed in 233 patients who were recruited in Hong Kong primary-care settings. The internal construct validity was assessed by corrected item-total correlation. The convergent validity was assessed using Pearson's correlation test against International Prostate Symptom Score (IPSS) quality-of-life question and Short Form 12, version 2 (SF-12v2). The reliability was assessed by the internal consistency (Cronbach's alpha coefficient) and 2-week test-retest reliability (intraclass correlation coefficient and paired t test). The sensitivity was determined by performing known group comparisons by independent t test.

RESULTS

Corrected item-total correlations were ≥0.4 for all items in males and females. Overall, the IIQ-7 total score had a stronger correlation with IPSS quality-of-life score than the SF-12v2. The IIQ-7 showed good internal consistency (Cronbach's alpha coefficient >0.7) and good test-retest reliability (ICC > 0.8, paired t test p value >0.05). The IIQ-7 was more sensitive than the SF-12v2 to detect differences among patients with different levels of symptom severity.

CONCLUSIONS

The IIQ-7 Chinese version appears to be a valid and reliable measure to assess Cantonese-speaking males and females with LUTS. The IIQ-7 is more sensitive than generic health-related quality-of-life measures to detect differences between groups.

[Prevalence and risk factors of urinary incontinence in women who visit the doctor with low back pain: multicentre study]

Objetivos

Estimar la prevalencia y los factores de riesgo de incontinencia urinaria (IU) en mujeres con dolor lumbopélvico (DLP) y describir sus características sociodemográficas y clínicas.

Diseño

Estudio observacional transversal.

Emplazamiento

Dos centros de Atención Primaria del Sur de Córdoba y un centro privado en Madrid.

Participantes

Trescientas sesenta y cuatro mujeres de 20-65 años (de 466 contactadas, 33 fueron excluidas y 69 rechazaron participar) que consultaron por dolor de espalda localizado entre la doceava costilla y el pliegue glúteo.

Intervenciones

Entrevista mediante cuestionario.

Mediciones principales

Cuestionarios (Índice de discapacidad de Oswestry y cuestionarios de IU [International Consultation on Incontinence Questionnaire SF e Cuestionario de Impacto de la Incontinencia-7]), prueba funcional (test ASLR) y comorbilidad de interés para la IU. Análisis estadístico descriptivo y multivariante.

Resultados

Se encontró IU en 155 mujeres (43%; IC del 95%, 37%-48%), en su mayoría de esfuerzo (83%) y mínimo impacto (60%). Frente a las continentes, las mujeres incontinentes presentaron diferencias significativas en la edad, el índice de masa corporal (IMC), el estado civil, el nivel de instrucción y la convivencia, el consumo de fármacos/día, el número de partos vaginales y totales, las intervenciones quirúrgicas abdominopélvicas, el asma, el estreñimiento, la hipertensión, la diabetes, el porcentaje de incapacidad y el test funcional ASLR. En el análisis multivariante, las variables que más influyen en la probabilidad de ser incontinente fueron el asma, la hipertensión, el estreñimiento, el número de partos totales, el IMC y el porcentaje de incapacidad.

Conclusiones

La prevalencia de IU en mujeres con DLP es mayor que la encontrada en mujeres de similar edad sin DLP. El asma, el estreñimiento y la paridad son los factores más influyentes en la aparición de IU.

[Urinary incontinence 6 months after childbirth]

BACKGROUND AND OBJECTIVE

Urinary incontinence initiated before and right after delivery and persisting 3 months after delivery tends to become chronic. We intended to estimate the persistence of urinary incontinence 6 months postpartum and to analyse the different factors associated with it.

PATIENTS AND METHODS

Follow-up study 6 months after delivery of women presenting urinary incontinence symptoms in gestation or in the first 2 months of postpartum. The dependent variable was the persistence and the independent variables were grouped in obstetric and non-obstetric. Odds ratio (OR) were calculated with their confidence interval at 95% (IC 95%) in the bivariate analysis. The variables that showed an important risk of persistence of incontinence were used to perform a multivariate model of logistic regression.

RESULTS

The persistence of incontinence 6 months after delivery was 21.4% (CI 95% 16-26.7). The risk of persistence increased with the Kristeller maneuver (OR 7.89, CI 95% 3.04-20.49), not weight recovery (OR 3.64, CI 95% 1.10-12.02), not practising pelvic floor muscle exercises in postpartum (OR 9.36, CI 95% 2.71-32.33), appearance of incontinence after delivery (OR 6.66, CI 95% 2.37-18.68) and the weight of the newborn>3.5 kg (OR 6.76, CI 95% 2.54-18.03), all of them explaining 58% of the variability of persistence.

CONCLUSION

21.4% of women with urinary incontinence caused by pregnancy/delivery will continue to have it 6 months postpartum. An important part of this persistence is associated with some factors easy to modify.