Assessment Tools & Questionnaires
Validated patient-reported outcome measures (PROMs), severity grading scales and objective assessment tools document baseline severity, inform surgical decisions and provide reproducible patient-reported or measured endpoints for follow-up and research in reconstructive urology and urogynecology. PROMs measure the patient’s experience; they are not objective anatomical tests.
Erectile and Sexual Function
SHIM / IIEF-5 (Sexual Health Inventory for Men)
SHIM is the 5-item short form of the International Index of Erectile Function (IIEF) and focuses on erectile function over the past 6 months.[1][2]
| Parameter | Detail |
|---|---|
| Questions | 5 — confidence, firmness for penetration, maintenance during intercourse, difficulty maintaining to completion, satisfaction |
| Scoring range | 1–25 |
| ED severity | Severe 1–7, moderate 8–11, mild-moderate 12–16, mild 17–21, no ED 22–25. A very low total needs clinical context when no sexual activity or intercourse was attempted; zero-coded inactivity alone does not establish severe ED.[1] |
| Time horizon | Past 6 months |
| Use the validated version | Preserve wording, recall period, response options and scoring; use an appropriately validated translation.[1] |
| Clinical role | Baseline ED assessment; response to PDE5i / VED / ICI; pre- and post-implant comparison |
Limitation. SHIM captures ED severity specifically, not broader sexual function. For the latter, use the sexual-function domain of EPIC (Expanded Prostate Cancer Index Composite) or the UCLA Prostate Cancer Index in prostate-cancer populations.[3]
Full IIEF (IIEF-15)
The full IIEF is a 15-item instrument covering 5 domains: erectile function, orgasmic or ejaculatory function, sexual desire, intercourse satisfaction, and overall satisfaction.[2]
Used in:
- Clinical assessment of male pelvic-floor disorders: the Pelvic Floor Disorders Consortium recommends IIEF-15, or an eight-item subset covering erectile, orgasmic or ejaculatory function and quality of life when brevity is needed.[2]
- Clinical trials requiring multidomain outcome capture
- Peyronie's disease work-up in combination with the PDQ (Peyronie's Disease Questionnaire) for psychosocial and sexual-function tracking
Female Sexual Function
For the clinical framework see Female Sexual Dysfunction. Use questionnaires to describe function, bother and change over time alongside the clinical interview.[23][24] Assess distress, the patient's goals, sexual activity and its context, medications, pain and other contributing conditions.[23][24]
FSFI-19 (Female Sexual Function Index)
FSFI-19 is a widely used multidomain sexual-function instrument.[24]
| Parameter | Detail |
|---|---|
| Items | 19 (self-report) |
| Domains | Desire, arousal, lubrication, orgasm, satisfaction, pain (6 domains) |
| Recall | 4 weeks |
| Scoring | Domain scores are weighted and summed (total 2–36). In a cross-validation of 568 women with and without diagnosed sexual dysfunctions, 26.55 was the optimal classification threshold; interpretation depends on the validation population and clinical context.[84] |
| Psychometrics (COSMIN SR, 83 studies) | Sufficient internal consistency (moderate-quality evidence), reliability (low-quality evidence) and criterion validity (high-quality evidence). Structural and construct validity were inconsistent; evidence on measurement error, responsiveness and cross-cultural validity was unavailable.[24] |
| Languages | Validated in English, Spanish, Arabic, Chinese, and at least 5 others |
| Limitations | Does not measure sexual distress. Some items assign zero for no activity. It has a pain domain but no separate labial/clitoral discomfort scales.[29] |
FSFI-6 and FSFI-9 (short forms)
- FSFI-6 samples all six domains, including pain. The COSMIN review found limitations in several measurement properties; choose the version and language validated for the intended use.[24][29]
- FSFI-9 was developed from 898 peri- and postmenopausal women with hot flashes as a shorter continuous outcome measure, particularly for secondary outcomes; that study did not establish a diagnostic cutoff against an expert clinical interview.[29] The Pelvic Floor Disorders Consortium recommends FSFI-9 when no pelvic-floor disorder is known or questionnaire brevity is a priority.[2]
FSDS / FSDS-R / FSDS-DAO (Female Sexual Distress Scale)
- FSDS is the 12-item distress instrument, refined from an initial 20-item version; FSDS-R has 13 items, adding a low-desire distress question. Do not apply the revised instrument's scoring rules or threshold to the original form.[25][30]
- FSDS-R measures distress separately from function. Its original validation involved 296 premenopausal women aged 18–50 with HSDD, another sexual dysfunction, or no dysfunction.[25] Seven- and 30-day recall periods were studied.[25]
- FSDS-DAO was adapted from the FSDS-R by adding two questions on arousal and orgasm (15 items). Its psychometric validation used a phase 2b bremelanotide trial (N = 325) in women with arousal disorder and/or hypoactive sexual desire disorder.[46] Specify the exact version and whether the total score or a single item is used.[85]
DSDS (Decreased Sexual Desire Screener)
DSDS is a brief 5-item diagnostic instrument designed for non-specialist clinicians to diagnose generalized acquired HSDD.[26]
| Parameter | Detail |
|---|---|
| Items | 4 patient yes/no items + 1 collaborative clinician item to rule out other causes |
| Time | Brief patient-and-clinician assessment |
| Sensitivity / specificity | 83.6% / 87.8% in the original 263-woman validation study |
| Diagnostic agreement with expert clinician interview | 85.2% (224/263); nonexpert clinicians judged the DSDS questions adequate in 92.9% (235/253) of cases.[26] |
| Scope | Generalized acquired HSDD |
SIDI-F (Sexual Interest and Desire Inventory–Female)
SIDI-F is a 13-item clinician-administered scale designed to measure HSDD severity, not general FSD.[27]
- The original study reported internal consistency of α 0.90, convergence with other sexual-function measures, and differences between HSDD, female orgasmic disorder and no-dysfunction groups.
- It is used to quantify HSDD severity and monitor treatment response.
PROMIS Sexual Function and Satisfaction (SexFS) v2.0
PROMIS SexFS v2.0 is a customizable, modular instrument with 11 scored scales: interest in sexual activity, lubrication, vaginal discomfort, clitoral discomfort, labial discomfort, erectile function, orgasm ability, orgasm pleasure, oral dryness, oral discomfort, satisfaction.[28]
- Scores centered on norms for sexually active US adults; applicable to both men and women, with or without a partner.
- Select only the domains relevant to the patient's concerns and use the official version-specific scoring. Dedicated labial and clitoral discomfort domains can help describe symptoms that a global score misses.[28]
PISQ-IR (Pelvic Organ Prolapse / Incontinence Sexual Questionnaire — IUGA Revised)
PISQ-IR is a condition-specific validated questionnaire for women with pelvic-floor disorders. Sexually active women answer 21 questions in 6 subscales (3 in each of 2 domains); sexually inactive women answer 12 questions in 4 subscales (2 in each of 2 domains).[47] The instrument includes separate sexually active and inactive pathways, including reasons for inactivity. Use the appropriate pathway and official scoring: a validated summary score is available for sexually active women, while the sexually inactive pathway uses subscales; active and inactive results remain separate.[31][74]
PISQ-IR revised an earlier instrument, and older outcome studies report the original PISQ or its short form, so the version should be identified when results are compared. The original PISQ (PISQ-31) is a self-administered, 31-item questionnaire in three domains (behavioral/emotive, physical and partner-related), validated in 182 women with urinary incontinence or pelvic organ prolapse against the Sexual History Form-12 and the Incontinence Impact Questionnaire-7.[68] The 12-item short form (PISQ-12) was derived by regression from the PISQ-31 data and validated in a further 46 women; its scores correlated with long-form scores (R = 0.75–0.95), with weighted kappa test-retest values of 0.56–0.93.[69]
Comparison Table
| Instrument | Items | Administration | Primary use | Domains |
|---|---|---|---|---|
| FSFI-19 | 19 | Self-report | Comprehensive FSD assessment | Desire, arousal, lubrication, orgasm, satisfaction, pain |
| FSFI-6 | 6 | Self-report | Brief FSD screening | One item from each of six domains, including pain |
| FSFI-9 | 9 | Self-report | Brief FSD assessment (peri / postmenopausal) | Abbreviated domains |
| FSDS | 12 | Self-report | Sexual-distress measurement | Global sexually-related distress |
| FSDS-R | 13 | Self-report | Distress (HSDD-sensitive) | Global distress + low-desire distress (Item 13) |
| FSDS-DAO | 15 | Self-report | Distress (desire / arousal / orgasm) | Distress specific to desire, arousal, orgasm |
| DSDS | 5 | Patient + clinician | HSDD diagnosis by non-specialists | Generalized acquired HSDD screening / diagnosis |
| SIDI-F | 13 | Clinician | HSDD severity measurement | Desire symptoms, comorbid factors |
| PROMIS SexFS v2.0 | Modular (11 scales) | Self-report | Customizable function assessment | Interest, lubrication, vulvar discomfort, orgasm, satisfaction |
| PISQ-IR | 21 active / 12 inactive | Self-report | Sexual function in pelvic-floor disorders | Condition-specific; captures sexual inactivity |
Choosing an instrument
Start with the patient's concern, then choose a function, distress or condition-specific measure that will inform care. FSFI and FSDS-R answer different questions and may be paired when both are relevant. DSDS supports the assessment of generalized acquired low desire. Avoid administering every questionnaire at each visit.[24][25][26][31]
Pelvic Organ Prolapse
POP-Q (Pelvic Organ Prolapse Quantification)
POP-Q standardizes vaginal support measurements relative to the hymen. Record the actual compartment measurements and examination conditions. The simplified POP-Q also has supporting reproducibility evidence. For landmark definitions, staging boundaries and a worked example, use the female pelvic examination page.[4][5]
PFDI-20 and PFIQ-7 (Pelvic Floor Distress / Impact)
- PFDI-20 (Pelvic Floor Distress Inventory-20): 20 items, range 0–300, distress from pelvic floor symptoms across three subscales (UDI-6 urinary, POPDI-6 prolapse, CRADI-8 colorectal-anal)[6]
- PFIQ-7 (Pelvic Floor Impact Questionnaire-7): 21 items total (7 per subscale), range 0–300, quality of life impact across urinary, prolapse and colorectal-anal domains (UIQ-7, POPIQ-7 and CRAIQ-7)[6]
Paired use captures both symptom distress and functional impact.
The PISQ-IR adds a sexual-function assessment when relevant; PFDI-20 and PFIQ-7 do not cover that domain.
Additional Prolapse and Pelvic-Floor Measures
- P-QoL (Prolapse Quality of Life) is a POP-specific quality-of-life questionnaire with domain scores from 0 to 100, higher indicating worse quality of life, plus separate symptom items not included in the domain scores.[49]
- POP-SS (POP-Symptom Score) is a brief 7-item measure of prolapse symptoms (each item 0–4, summed range 0–28) with a separate item identifying the most bothersome symptom. Internal consistency (Cronbach's alpha) ranged from 0.723 to 0.828 across postpartum, pelvic-floor-muscle-training and POP-surgery cohorts.[50] A 2025 COSMIN review of 13 prolapse PROMs found POP-SS the only measure with sufficient evidence of adequate construct validity and responsiveness in both conservative and surgical settings.[72]
- ICIQ-VS (ICIQ Vaginal Symptoms Questionnaire) is a 14-item self-completion measure of vaginal symptoms and sexual matters attributed to prolapse, scored separately for vaginal symptoms (0–53), sexual matters (0–58) and quality-of-life impact (0–10). Internal consistency in the original validation was 0.79 for the vaginal-symptom dimension and 0.84 for the sexual-symptom dimension.[51]
- PGI-I (Patient Global Impression of Improvement) is a single-item, seven-level global rating of change after treatment, from very much improved to very much worse; it has been validated for women undergoing POP surgery as well as for urinary incontinence.[52]
- ePAQ-PF is an adaptive electronic questionnaire spanning urinary, bowel, vaginal and sexual domains. In the original 432-woman development cohort, Cronbach's alpha was at least 0.7 in all primary-care domains but only 11 of 14 secondary-care domains; primary-care test-retest intraclass correlations ranged from 0.50 to 0.95.[53] In a separate prospective cohort of 390 women undergoing urodynamics, ePAQ-PF domain scores predicted detrusor overactivity (AUC 0.70) and urodynamic stress incontinence (AUC 0.73) with fair accuracy.[54]
- APFQ (Australian Pelvic Floor Questionnaire) is an interviewer-administered questionnaire covering bladder, bowel and sexual function and prolapse, with severity, bother and condition-specific quality of life. It was validated in 106 urogynecology patients and a community cohort of 49 women; domains correlated with the UDI-6, a bowel questionnaire, POP-Q and the McCoy Female Sexuality Questionnaire, and test-retest kappa ranged from 0.5 to 1.0.[70]
For a more detailed bowel-specific measure than the PFDI-20/PFIQ-7 colorectal-anal subscales, the ICIQ-B is a 21-item patient-completed questionnaire with 17 items across three scored domains (bowel pattern, bowel control, quality of life) and four unscored items, validated in 261 patients with anal incontinence.[55]
Urinary Incontinence — Objective Severity
Pad Weight Tests
Pad weighing quantifies leakage during a specified test period. Record duration, bladder preparation, activities, collection completeness and pad handling. A one-hour test with standardized activities and a 24-hour test during usual activity answer somewhat different questions; neither is a universal gold standard for all incontinence outcomes.[7][8]
| Test | Useful role | Important limitation |
|---|---|---|
| One-hour ICS protocol | Reproducible instructions for a short provocation assessment | Leakage depends on bladder volume and activity. |
| 24-hour test | Quantifies urine loss during everyday activity; may help with treatment selection and follow-up | Depends on collection completeness, fluid intake, activity and storage to limit evaporation; repeat under comparable conditions. |
| Longer tests | Selected research or assessment of day-to-day variation | More burdensome. |
There is no universal abnormal threshold of 15 g. Interpret results using the specific protocol and population.[7][8] Pad weights do not reliably distinguish stress from urgency incontinence.[7][8]
Pad-weight gain is also not specific to urine: vaginal discharge and perspiration can contribute. Older observational studies reported a mean 1.2 g pad gain per two-hour interval from perspiration alone in six healthy volunteers, and a mean pad gain of less than 1 g/h among 50 continent women compared with 12.2 g/h among 100 incontinent women during one-hour pad testing.[56][57]
NICE advises against routine pad tests in the initial assessment of women with urinary incontinence. Selective use for a defined clinical question or research outcome is different from requiring one for every patient.[32]
MSIGS (Male Stress Incontinence Grading Scale)
MSIGS is an observed leakage scale developed for men with post-prostatectomy stress incontinence. In the original protocol, the patient had not voided for at least an hour and performed four forceful coughs while standing.[33] The pilot did not standardize bladder volume.[33]
| Grade | Observed leakage |
|---|---|
| 0 | Reports leakage but none demonstrated during the test |
| 1 | Delayed drops only |
| 2 | Early drops, no stream |
| 3 | Early drops, delayed stream |
| 4 | Early and persistent stream |
Clinical utility: Adds prognostic value to pads-per-day in predicting transobturator sling success; incorporated into the Shakir refined nomogram for sling candidate selection. In a 2025 review of fixed slings for post-prostatectomy incontinence (62 cohorts, 5,696 men), higher MSIGS grade was associated with sling failure with moderate-certainty evidence from one adjusted analysis; pelvic irradiation, 24-hour pad use and 24-hour urine loss had high-certainty prognostic evidence.[75] For counseling, consider radiation, prior procedures, bladder function, patient preferences and ability to operate an AUS.[9]
Voiding / Bladder Diaries
A diary, commonly collected over 3 days, records fluid intake, voiding events and incontinence episodes. It captures storage LUTS, identifies modifiable factors (fluid volume, caffeine, diuretic timing), and monitors response to treatment.[10][11]
ICIQ Bladder Diary (validated)
The 3-day ICIQ bladder diary is a validated option.[12] Records:
- Time and volume of each void
- Fluid intake (type and volume)
- Incontinence episodes (write LEAK in the urine-output column)[76]
- Pad use
- A patient-rated bladder-sensation score at each micturition
AUA/SUFU OAB guidance. Clinicians may obtain a symptom questionnaire and/or voiding diary to support diagnosis, exclude other disorders, ascertain bother and evaluate treatment response .[11]
Role alongside urodynamics. The diary is complementary to urodynamics; it is more accessible and affordable and can be completed at home.[10] A diary does not measure detrusor pressure.[10]
Overactive Bladder
Use one symptom measure and the same version at every visit. Any of these can supplement a bladder diary; none replaces the clinical evaluation. Instruments developed in trials or single-country cohorts may need local validation before wider use.
| Instrument | Structure | Features |
|---|---|---|
| OAB-q | 33 items: symptom-bother and health-related quality-of-life scales | Validated in a community sample (n = 254) and a treatment-seeking clinical sample (n = 736); discriminated normal, continent-OAB and incontinent-OAB participants[38] |
| ICIQ-OAB | Module of the ICIQ modular questionnaire | Urinary-symptom module for OAB features and bother[39] |
| OABSS | 4 items scored 0–15 (daytime frequency, nocturia, urgency, urgency incontinence) | Developed in Japan; separated OAB (mean 8.36) from other groups (1.82–5.14); posttreatment change tracked patient global impression[40] |
| Urgency Severity Scale (USS) | Patient-reported urgency severity, event-based | Validated as the Indevus Urgency Severity Scale alongside a phase III trospium trial (658 patients) for clinical-trial use[41] |
| OAB-BAT (OAB Bladder Assessment Tool) | 17 items in the developed form, 7-day recall | An eight-item unidimensional model of symptom bother and impact forms a scored 0–100 T-score; separate symptom-frequency and treatment-satisfaction items are not scored. Validated in a 170-patient observational study as a potential complement to the bladder diary[58][59] |
Interstitial Cystitis / Bladder Pain Syndrome
These instruments document symptom burden and response. Diagnosis and management are covered on the IC/BPS page.
| Instrument | Structure | Features |
|---|---|---|
| ICSI / ICPI (O'Leary-Sant Symptom and Problem Indices) | Two brief self-administered indices: symptoms (urinary and pain) and how problematic they are | Developed for IC with focus groups and a validation sample of 45 patients and 67 controls; good internal consistency, construct validity and test-retest reliability. A 1.2-point change corresponded to one Global Response Assessment category in a later trial analysis[42][45] |
| PUF (Pelvic Pain and Urgency/Frequency scale) | Symptom scale covering urgency/frequency, pelvic pain and pain with intercourse | In the original potassium sensitivity study, 74% of patients scoring 10–14 and 91% scoring 20 or more had a positive test; in a separate 220-patient urology cohort, PUF scores of 13 or higher supported further evaluation but lacked specificity for IC/BPS diagnosis. PUF can track symptoms; potassium testing is nonspecific and is not recommended for routine diagnosis.[43][71][83] |
| GUPI (Genitourinary Pain Index) | Modified NIH-CPSI for men and women[65] | Discriminated IC and chronic prostatitis from other conditions among 1,653 men and 1,403 women in managed care; correlated highly with ICSI/ICPI among 82 women and 14 men diagnosed with IC; among 47 men and women who completed a pilot trial comparing myofascial physical therapy with global therapeutic massage, a 7-point reduction predicted moderate or marked improvement on a global response item (sensitivity 100%, specificity 76%)[44] |
| GRA (Global Response Assessment) | Patient-reported global rating of change from baseline | Used as the anchor for responsiveness of the O'Leary-Sant and Wisconsin IC scales; use the same wording and time point at each assessment[45] |
Pain intensity is often tracked with a visual analog or numeric rating scale (VAS/NRS) alongside these instruments.
Lower Urinary Tract Symptoms
| Instrument | Population | Features |
|---|---|---|
| IPSS (International Prostate Symptom Score) | Primarily men with LUTS | 7 symptom items (0–35) plus a separate QoL item (0–6)[35] |
| ICIQ-UI SF | Men and women | Four items: three scored frequency/amount/impact items produce 0–21; the leakage-circumstances item is unscored.[34] In women with SUI, EAU 2026 lists it among the five most-reported validated PROMs (with PGI-I, UDI-6, IIQ-7 and KHQ), states that no single questionnaire meets every requirement for assessing SUI, and notes no evidence that using QoL or condition-specific questionnaires changes treatment outcome.[48] |
| ICIQ-LUTSqol | People with urinary incontinence | Quality-of-life impact of leakage, adapted from the King’s Health Questionnaire; select a validated language/version.[36] |
| ICIQ-MLUTS / ICSmaleSF | Men | ICIQ-MLUTS developed from the ICS male questionnaire; captures individual urinary symptoms and bother, including incontinence.[35] |
| LURN-SI-29 / LURN-SI-10 | All genders | Voiding, storage, and incontinence symptoms; validated across genders[11] |
| ICIQ-FLUTS (derived from BFLUTS-SF) | Women | Twelve symptoms across filling, voiding and incontinence domains, each with a separate 0–10 bother rating excluded from symptom subscale scores.[82] The scored BFLUTS form was developed using data from a 344-woman randomized trial of stress-incontinence surgery.[11][60] |
IPSS does not directly ask about incontinence or post-micturition dribble, and its single global quality-of-life item does not identify which symptom is driving bother; ICIQ-MLUTS scores these symptoms individually.[61]
Incontinence-Specific
| Instrument | Purpose |
|---|---|
| ISI (Incontinence Symptom Index) | Severity and bother measure used in the cited male AUS cohort. Specify the actual instrument/version; do not confuse it with the similarly abbreviated Incontinence Severity Index.[15] |
| IIQ-7 (Incontinence Impact Questionnaire-7) | Life impact of urinary incontinence; a separate instrument from the UIQ-7 within PFIQ-7.[37] |
| UDI-6 (Urogenital Distress Inventory-6) | Six urinary symptom-distress items, also used within PFDI-20; preserve the exact instrument’s response options and scoring.[6][37] |
| I-QOL (Incontinence Quality of Life Questionnaire) | 22-item, longer condition-specific quality-of-life measure for urinary incontinence, used when more detail than IIQ-7 is needed.[62] |
Urethral Stricture Disease
USS-PROM (Urethral Stricture Surgery PROM)
USS-PROM is a disease-specific PROM developed for men undergoing anterior urethral reconstruction; it combines LUTS, health-status (EQ-5D), and treatment satisfaction items.[16][17]
Clinical role. Baseline documentation and longitudinal tracking before and after urethroplasty. USS-PROM is administered in a validated language and version; USSIM is a patient-derived alternative with urinary and sexual symptom items, validated in 2025 and externally validated in German in 2026 among men undergoing anterior urethroplasty.[78][79]
Urethral Stricture Score
Keep anatomical classification separate from the patient-reported USS-PROM. LSE describes length, segment and etiology; the Urethral Stricture Score (USS) incorporates additional stricture characteristics.[18][19] A five-stage LSE system, developed from the TURNS prospective database and validated separately, predicted multistage or nonorthotopic-meatus repair better than numeric LSE or U-scores, with similar prediction of surgical outcomes.[80]
In the cited 2022 retrospective comparison of 187 men, LSE was associated with recurrence whereas USS was not.[18]
Other Validated Tools
| Instrument | Domain |
|---|---|
| EPIC (Expanded Prostate Cancer Index Composite) | Prostate-cancer treatment outcomes: urinary incontinence, urinary irritation/obstruction, bowel, sexual and hormonal domains; used in the ProtecT comparison of patient-reported outcomes after active monitoring, prostatectomy and radiotherapy for localized prostate cancer[14] |
| NIH-CPSI (NIH Chronic Prostatitis Symptom Index) | Pain, urination, and overall impact in chronic prostatitis / CPPS[20][65] |
| ICIQ-S (ICIQ-Satisfaction) | Satisfaction instrument initially validated in 410 men undergoing surgery for benign prostatic obstruction; broader reconstructive use needs appropriate validation[21] |
| EQ-5D | Generic health-related quality of life; component of USS-PROM and many other disease-specific bundles[16][17][22] |
| PDQ (Peyronie's Disease Questionnaire) | Peyronie's-specific psychological and physical symptoms, penile pain and symptom bother domains[77] |
For localized prostate cancer, the AUA/ASTRO discussion of Statements 9 and 45 (Clinical Principles) supports assessing urinary, bowel and sexual function before treatment and routinely during follow-up with standardized instruments. It identifies EPIC-26 or EPIC-CP for multidomain assessment, SHIM or IIEF for erectile function, and ICSmaleSF or ICIQ for continence.[66]
Before salvage radiotherapy after radical prostatectomy, the AUA/ASTRO/SUO 2024 discussion of Statement 4 also advises standardized assessment of urinary, bowel and sexual function to support counseling about additional treatment risks.[67]
How to Use These in Practice
Choose a small set that answers the patient's clinical question, using the same version and recall period at follow-up:
| Clinical concern | Reasonable starting assessment |
|---|---|
| Erectile dysfunction | SHIM or full IIEF according to the information needed; add a Peyronie's-specific measure when relevant. |
| Male LUTS | IPSS with its separate QoL item; add a diary or incontinence measure for the relevant symptoms. |
| Male stress incontinence | Patient-reported severity/bother, pad use and observed cough leakage; consider a pad-weight test when it will inform care. |
| Prolapse | POP-Q plus a symptom/bother measure; add life-impact or sexual-function assessment according to concerns, including inactivity when relevant. |
| Female incontinence | A brief validated symptom/impact measure and a bladder diary; NICE recommends at least three representative days. Additional questionnaires and pad tests are selective.[32] |
| Male anterior urethral stricture | USS-PROM with anatomical evaluation and follow-up. The EAU 2026 guideline strongly recommends a validated symptom and quality-of-life PROM and a validated sexual-function tool for men undergoing urethral stricture surgery; record patency, retreatment, continence and satisfaction separately.[81] A 2026 international Delphi proposed freedom from retreatment, no significant continence or sexual-function impact, and patient satisfaction as core reporting criteria; this is a consensus framework.[13][73] |
Avoid duplicate items, such as administering UDI-6 separately when it is already contained in PFDI-20. Keep the original scoring, missing-item rules and validated translations when using an instrument. A new population, altered wording or a different recall period may require validation.
For highly personal or intimate questions, self-administration where feasible can reduce interviewer-related response bias and burden. Preserve the validated administration mode, and establish measurement equivalence before treating a paper and an electronic version of the same instrument as interchangeable.[63][64]
When symptoms and a measured result differ, investigate test conditions and what each instrument measures. Record both and use them to guide the next assessment.
See Also
- Female Pelvic Examination & POP-Q. Including POP-Q technique
- Male Urogenital Exam
- Urodynamics
- Erectile Dysfunction. Clinical use of SHIM and IIEF
- Peyronie's Disease. PDQ and IIEF in workup
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