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

Lukacz, Emily S.; Lawrence, Jean M.; Buckwalter, J. Galen; Burchette, Raoul J.; Nager, Charles W.; Luber, Karl M.

doi:10.1007/s00192-005-1314-5

Cited by 122 publications

(108 citation statements)

References 42 publications

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“…Symptoms of pelvic floor disorders were assessed using the Epidemiology of Prolapse and Incontinence Questionnaire, a validated self-administered questionnaire (14). This questionnaire generates scores for four pelvic floor disorders: stress urinary incontinence (SUI), overactive bladder (OAB), anal incontinence and pelvic organ prolapse (POP).…”

Section: Discussionmentioning

confidence: 99%

“…In each case, a validated threshold is used to define women who meet criteria for the disorder. Scores greater than these threshold values have been shown to correspond to significant bother from pelvic floor symptoms (14). In this research, we used the published thresholds (14) to distinguish women with and without each pelvic floor disorder.…”

Section: Discussionmentioning

confidence: 99%

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Pelvic Floor Disorders 5–10 Years After Vaginal or Cesarean Childbirth

Handa¹,

Blomquist

Knoepp

et al. 2012

Obstetric Anesthesia Digest

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Objective-To estimate differences in pelvic floor disorders by mode of delivery.Methods-We recruited 1,011 women for a longitudinal cohort study, 5-10 years after first delivery. Using hospital records, we classified each birth as: cesarean without labor, cesarean during active labor, cesarean after complete cervical dilation, spontaneous vaginal birth, or operative vaginal birth. At enrollment, stress incontinence, overactive bladder, anal incontinence, and prolapse symptoms were assessed with a validated questionnaire. Pelvic organ support was assessed using the Pelvic Organ Prolapse Quantification system. Logistic regression analysis was used to estimate the relative odds of each pelvic floor disorder by obstetric history, adjusting for relevant confounders.Results-Compared to cesarean without labor, spontaneous vaginal birth was associated with a significantly greater odds of stress incontinence (odds ratio (OR) 2.9; 95% confidence interval (CI) 1.5, 5.5) and prolapse to or beyond the hymen (OR 5.6; 95% CI 2.2, 14.7). Operative vaginal birth significantly increased the odds for all pelvic floor disorders, especially prolapse (OR 7.5; 95% CI 2.7, 20.9). These results suggest that 6.8 additional operative births or 8.9 spontaneous vaginal births, relative to cesarean births, would lead to one additional case of prolapse. Among women delivering exclusively by cesarean, neither active labor nor complete cervical dilation increased the odds for any pelvic floor disorder considered, although the study had less than 80% power to detect a doubling of the odds with these exposures.Conclusion-Although spontaneous vaginal delivery was significantly associated with stress incontinence and prolapse, the most dramatic risk was associated with operative vaginal birth.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pelvic Floor Disorders 5–10 Years After Vaginal or Cesarean Childbirth

Handa¹,

Blomquist

Knoepp

et al. 2012

Obstetric Anesthesia Digest

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“…In addition to the 42-item validation version of the questionnaire, women also completed the Incontinence Severity Index (ISI) [16], a single question evaluating prolapse and its bother (question #35) from the Epidemiology of Prolapse and Incontinence Questionnaire (EPIQ) [17], the Pelvic Floor Distress Inventory-20 (PFDI-20) [18][19][20], and the FSFI [5,21]. The first step in the analysis was to describe the basic distribution of patient and clinical characteristics.…”

Section: Methodsmentioning

confidence: 99%

A new measure of sexual function in women with pelvic floor disorders (PFD): the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR)

et al. 2013

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Introduction and hypothesis The objective of this study was to create a valid, reliable, and responsive sexual function measure in women with pelvic floor disorders (PFDs) for both sexually active (SA) and inactive (NSA) women. Methods Expert review identified concept gaps and generated items evaluated with cognitive interviews. Women underwent Pelvic Organ Prolapse Quantification (POPQ) exams and completed the Incontinence Severity Index (ISI), a prolapse question from the Epidemiology of Prolapse and Incontinence Questionnaire (ISI scores), the Pelvic Floor Distress Inventory-20 (PFDI-20), and the Female Sexual Function Index (FSFI). Principle components and orthogonal varimax rotation and principle factor analysis with oblique rotation identified item grouping. Cronbach's alpha measured internal consistency. Factor correlations evaluated criterion validation. Change scores compared to change scores in other measures evaluated responsiveness among women who underwent surgery. Results A total of 589 women gave baseline data, 200 returned surveys after treatment, and 147 provided test-retest A related editorial can be found at

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“…Surveys in English and Spanish were mailed with a cover letter, small incentive, and postcard to opt-out or request additional information, followed by a second survey mailing, a reminder telephone call, and a third survey mailing to women in the youngest age strata (31 (30).…”

Section: Research Design and Methods -Kaisermentioning

confidence: 99%

Pelvic Floor Disorders, Diabetes, and Obesity in Women

et al. 2007

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OBJECTIVE -We examined associations between obesity and diabetes and female pelvic floor disorders (PFDs), stress urinary incontinence (SUI), overactive bladder (OAB), and anal incontinence (AI) in community-dwelling women.RESEARCH DESIGN AND METHODS -Women were screened for PFD using a validated mailed survey. Diabetes status, glycemic control, and diabetes treatment were extracted from clinical databases, while other risk factors for PFDs were obtained through self-report. Women were categorized hierarchically as nonobese/nondiabetic (reference), nonobese/ diabetic, obese/nondiabetic, and obese/diabetic. CONCLUSIONS -Given the impaired quality of life experienced by women with PFDs, health care providers should counsel women that obesity and diabetes may be independent modifiable risk factors for PFDs. RESULTS Diabetes Care 30:2536-2541, 2007D iabetes, obesity, and incontinence are all common health problems for women in the U.S. It has been estimated that 9.7 million, or 8.8%, of all women aged Ն20 years had diabetes in 2005 (1), while almost 50% may experience urinary incontinence in their lifetime (2). In [2003][2004]28.6% of women were overweight and 33.2% were obese (3). Urinary incontinence alone accounts for the expenditure of up to 19.5 billion dollars annually in the U.S. (4) and can have a significant impact on the quality of womens' lives (5).Studies (6 -12) have demonstrated the association between urinary incontinence and diabetes, and some (11,12) have found that women who used insulin were more likely to be incontinent than women with diabetes who did not require insulin, but the mechanisms are unclear. It has been suggested that the most likely reason for the increase in risk is microvascular compromise, leading to damage to the urethral sphincter mechanism and bladder sensitivity, and that stricter glycemic control may reduce the risk or severity of urinary incontinence (13). Studies (14,15) of the relationship between anal incontinence and diabetes have had conflicting results.Strong associations between obesity and both urinary and fecal incontinence have been reported (16 -24). The pathophysiologic basis posited for this relationship lies in the significant correlation between BMI and intra-abdominal pressure, suggesting that obesity may stress the pelvic floor secondary to a chronic state of increased pressure (25). Weight loss has been shown to improve incontinence in obese women (26 -28).In this secondary analysis of data from the KP CARES (Kaiser Permanente Continence Associated Risk Epidemiology Study) study, we examined associations between female pelvic floor disorders (PFDs) (stress urinary incontinence [SUI], overactive bladder [OAB], and anal incontinence [AI]) and diabetes and obesity. Pelvic organ prolapse was excluded from these analyses due to insufficient power to assess the associations of interest for this condition. We sought to evaluate the relative importance of the associations between diabetes and obesity in their contributions to PFDs. RESEARCH DESIGN AND METHODS -Kai...

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

Cited by 122 publications

References 42 publications

Pelvic Floor Disorders 5–10 Years After Vaginal or Cesarean Childbirth

Pelvic Floor Disorders 5–10 Years After Vaginal or Cesarean Childbirth

A new measure of sexual function in women with pelvic floor disorders (PFD): the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR)

Pelvic Floor Disorders, Diabetes, and Obesity in Women

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