COSMIN database

Questionnaires to assess urinary and anal incontinence: review and recommendations

Avery, K. N., Bosch, J. L., Gotoh, M., Naughton, M., Jackson, S., Radley, S. C., Valiquette, L., Batista, J., and Donovan, J. L.
PURPOSE: We reviewed and provide recommendations about the most scientifically robust and appropriate questionnaires for evaluating symptoms and the quality of life impact of urinary and/or anal incontinence, and vaginal and pelvic floor problems. We also investigated the use of these questionnaires in randomized, controlled trials of treatment strategies.

MATERIALS AND METHODS: The Symptom and Quality of Life Committee of the International Consultation on Incontinence performed a systematic review of questionnaires related to urinary and anal incontinence, and vaginal and pelvic floor problems, searching MEDLINE, The Cochrane Library and other electronic databases between 2001 and 2004.

RESULTS: A total of 23 robust and relevant questionnaires could be recommended in clinical practice and research. The development of questionnaires to assess anal incontinence, and pelvic floor and vaginal problems has been limited with some promising measures but with none achieving the highest level of rigor. From 2001 to 2004 there were 150 published randomized trials of treatments for incontinence. Increasingly trials of incontinence are using recommended measures (38% of those for urinary incontinence and 22% of those for anal incontinence used the highest quality questionnaires in 2001 to 2004) but none of vaginal and pelvic floor problems used recommended questionnaires.

CONCLUSIONS: With increasing acknowledgment of the value of patient based assessment much attention has been given to the development of questionnaires to assess symptoms and quality of life. Sufficient measures are now available for urinary incontinence, and researchers and clinicians are encouraged to use the 18 achieving the highest level of rigor and their validated translations. In contrast, the development of questionnaires for anal incontinence and pelvic/vaginal problems is in its infancy and further study in this area is needed. Randomized trials of treatments for incontinence should use only questionnaires achieving the highest level of scientific rigor.
J Urol
0022-5347 (Print)
Publication year:
Biological and physiological variables:
Biological and physiological variables
General health perceptions / HRQoL:
Self-rated health
Adults (18-65)
Children (0-18)
Seniors (65+)
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews
3 - Diaries
6 - Clinical rating scales
BBUSQ - Birmingham Bowel and Urinary Symptoms Questionnaire
BFLUTS - Bristol Female Lower Urinary Tract Symptoms Questionnaire (versions: BFLUTS-SF - BFLUTS-Short Form)
Bowel Disease Questionnaire
Danish Prolapse Questionnaire
Danish Prostatic Symptom Score
Elderly Bowel Symptoms Questionnaire
e-PAQ - Electronic PF Symptoms Assessment Questionnaire
FIQ - Fecal Incontinence Questionnaire (versions: C-FIQ - Comprehensice-FIQ)
FIQL - Fecal Incontinence Quality of Life Scale   
Gastrointestinal QOL Index
ICIQ - International Consultation on Incontinence Questionnaire (versions: ICIQ-SF; ICIQ-FLUTS; ICIQ-Bowel; ICIQ-VS)   
ICS male
ICS male SF
IIQ-7 - Incontinence Impact Questionnaire-7 items   
IIQ - Incontinence Impact Questionnaire (versions: IIQ-R; IIQ-male)   
I-QOL - Incontinence Quality of Life Instrument
KHQ - King's Health Questionnaire
Manchester Health Questionnaire
OAB-q - Overactive Bladder Questionnaire (versions: OAB-q SF)
PFDI - Pelvic Floor Distress Inventory (versions: PFDI-20; PFDI-46)
PF Dysfunction Questionnaire - Pelvic Floor Dysfunction Questionnaire
PFIQ - Pelvic Floor Impact Questionnaire (versions: PFIQ-7; PFIQ-31)
Postpartum Flatal and Fecal Incontinence QOL Scale
SEAPI-QMM - Stress-related leak, Emptying ability, Anatomy (female), Protection, inhibition, Quality of life, Mobility and Mental status
UDI - Urogenital Distress Inventory (versions: UDI-6 items)   
UISS - Urinary Incontinence Severity Index