Identification of the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire—IUGA Revised (PISQ-IR) Cutoff Scores for Impaired Sexual Function in Women with Pelvic Floor Disorders

Abstract

The aim of this cross-sectional study was to determine the cutoff scores for sexual dysfunction in disease-specific Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-IUGA Revised (PISQ-IR) for women with pelvic floor disorders (PFD). Medical history and urogynecological data of 521 women with PFD were collected. The subjects provided information about their sexual activity and completed Female Sexual Function Index (FSFI) and PISQ-IR questionnaires. Sexually active (SA) women were further analyzed and categorized using their FSFI scores: <26.55-sexual dysfunction, >26.55-no sexual dysfunction. Receiver operating characteristics (ROC) curve tested how well PISQ-IR allowed to discriminate between patients with and without sexual disorders. Area under curve (AUC) was calculated to measure the PISQ-IR Summary Score efficiency in the prediction. The cutoff values which minimalize (1-specifity) and maximize sensitivity were selected. In the analyzed cohort, 250 (48%) women were SA and a total of 226 SA were recruited for the study: 143 (63.3%) with <26.55 FSFI and 83 (36.7%) with >26.55 FSFI (response rate: 90.4%). Using ROC curve analysis, PISQ-IR Summary Score of 2.68 was determined to be the optimal cutoff for distinguishing between dysfunctional and nondysfunctional women (AUC = 0.85), allowing to diagnose sexual dysfunction in SA women with PFD, with 90% sensitivity and 71% specificity.

Responsiveness of two sexual function questionnaires: PISQ‐IR and FSFI in women with pelvic floor disorders

“…The score of less than 2.68 (with value ranges between 1.545 and 3.909) was established as indicative of sexual dysfunction in sexually active women with PFD. 17 FSFI can be calculated only in sexually active patients, 18 therefore PISQ-IR, which includes sexually active as well as inactive women, seems to have the advantage over FSFI in terms of applicability among women with PFD. Fifteen of the FSFI items contain a "zero option" in the response set to indicate either "no sexual activity" or "did not attempt intercourse" within the past 4 weeks.…”

“…An attempt was made to find the cutoff scores for distinguishing between dysfunctional and non‐dysfunctional women, based on the PISQ‐IR Summary Score. The score of less than 2.68 (with value ranges between 1.545 and 3.909) was established as indicative of sexual dysfunction in sexually active women with PFD 17 …”

“…However, the scores of domains with transformed summation are also presented (Table A1). In SA women, it is possible to calculate the Summary Score 12,17 …”

“…In SA women, it is possible to calculate the Summary Score. 12,17 The FSFI is a 19-item, self-report measure of female sexual function which provides scores on the overall levels of sexual function as well as the primary components of sexual function, including sexual desire, arousal, orgasm, pain, and satisfaction, in women. 18 Its discriminant validity has been confirmed for a wide range of sexual dysfunctions.…”

Commentary: The Vaginal and Urinary Microbiomes in Premenopausal Women With Interstitial Cystitis/Bladder Pain Syndrome as Compared to Unaffected Controls: A Pilot Cross-Sectional Study

“…For instance, in the Condition Impact domain the authors presented the results as 12.36 ± 3.57, which is the simple summation. The mean calculation system would present the scores as a sum of points (including appropriate reverse responses) divided per number of items answered with range 1.0-4.0 for that domain (Grzybowska et al, 2019). In a transformed summation, the mean scores would be transformed to a 0-100 range in each domain.…”