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Responsiveness of the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire in women undergoing treatment for pelvic floor disorders

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Abstract

Introduction and hypothesis

This study evaluated the responsiveness and minimal important differences (MID) of the Chinese Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) in women undergoing urodynamic stress incontinence (USI) and/or pelvic organ prolapse (POP) treatment.

Methods

One hundred and fifty-six women were assessed using the PFDI and PFIQ before and after they received continence surgery and or pelvic floor repair (PFR) surgery, or vaginal pessary. Symptom severity was recorded using a visual analog scale (VAS) before and after treatment as was rating of their satisfaction with the treatment they received. Responsiveness of the PFDI and PFIQ were evaluated by effect sizes, standardized response mean, paired samples t test or Wilcoxon Signed Rank Test. MID in the PFDI and PFIQ for different treatments were determined by satisfaction rating, change in VAS scoring, and distribution-based methods.

Results

There were significant improvements in the respective subscales of PFDI and PFIQ, demonstrating moderate to great responsiveness after different treatments. The estimation of MID for the Urinary Distress Inventory (UDI) was −30 to −14 and the Urinary Impact Questionnaire (UIQ) was −28 to −14 for women who underwent continence surgery. The MID for the Pelvic Organ Prolapse Distress Inventory (POPDI) was −44 to −21, the Pelvic Organ Prolapse Impact Questionnaire (POPIQ) −40 to −27, the UDI −22 to −16, the UIQ −37 to −31, the Colo-Rectal-Anal Distress Inventory (CRADI) −37 to −14, and the Colo-Rectal-Anal Impact Questionnaire (CRAIQ) −34 to −6 for women who underwent PFR surgery; and estimation of MID for the POPDI was −16, the POPIQ −29, the UDI −28, the UIQ −17, the CRADI −25, and the CRAIQ −31 for women who received a vaginal pessary. The MID of the respective subscales were supported by the distribution-based methods.

Conclusions

The Chinese PFDI and PFIQ instruments are responsive to change in women undergoing continence surgery, PFR surgery or vaginal pessary for USI or POP.

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Abbreviations

CRADI:

Colo-Rectal-Anal Distress Inventory

CRAIQ:

Colo-Rectal-Anal Impact Questionnaire

ES:

Effect sizes

HRQOL:

Health-related quality of life

ICS:

International Continence Society

MID:

Minimal important differences

PFDI:

Pelvic Floor Distress Inventory

PFIQ:

Pelvic Floor Impact Questionnaire

PFR:

Pelvic floor repair

POP:

Pelvic organ prolapse

POPDI:

Pelvic Organ Prolapse Distress Inventory

POPIQ:

Pelvic Organ Prolapse Impact Questionnaire

POP-Q:

Pelvic organ prolapse quantification

QOL:

Quality of life

SD:

Standard deviation

SEM:

Standard error of measurement

SRM:

Standardized response mean

TVT-O:

Transobturator tension free transvaginal tape surgery

UDI:

Urinary Distress Inventory

UIQ:

Urinary Impact Questionnaire

USI:

Urodynamic stress incontinence

VAS:

Visual analog scale

VHPFR:

Vaginal hysterectomy and anterior and or posterior colporrhaphy

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Conflicts of interest

None.

Grant support

This study obtained a grant from the Health and Health Service Research Fund (HHSRF) from the Food and Health Bureau of Hong Kong SAR.

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Authors and Affiliations

  1. Department of Obstetrics & Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong

    Symphorosa Shing Chee Chan, Rachel Yau Kar Cheung, Beatrice Pui Yee Lai, Lai Loi Lee, Kwong Wai Choy & Tony Kwok Hung Chung

  2. Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong

    Symphorosa Shing Chee Chan

Authors
  1. Symphorosa Shing Chee Chan
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  2. Rachel Yau Kar Cheung
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  3. Beatrice Pui Yee Lai
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  4. Lai Loi Lee
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  5. Kwong Wai Choy
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  6. Tony Kwok Hung Chung
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Correspondence to Symphorosa Shing Chee Chan.

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Chan, S.S.C., Cheung, R.Y.K., Lai, B.P.Y. et al. Responsiveness of the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire in women undergoing treatment for pelvic floor disorders. Int Urogynecol J 24, 213–221 (2013). https://doi.org/10.1007/s00192-012-1827-7

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  • DOI: https://doi.org/10.1007/s00192-012-1827-7

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