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11/3/2014 » 11/4/2014
Annual Scientific Update in Urogynaecology

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Ovarian Club IV

PISQ-IR: Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire
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Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR) Articles and Questionnaire Have Been Published Online!

There are now 3 articles available through the IUJ online website. The following two articles are available to those with online access to the IUJ:
- The Pelvic Organ Prolapse Incontinence Sexual Questionnaire, IUGA-revised (PISQ-IR)
- The PISQ-IR: considerations in scale scoring and development
The third article, A new measure of sexual function in women with pelvic floor disorders (PFD): the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR), has been given permanently free access and can be viewed and downloaded by clicking here.
The actual questionnaire is included as supplementary material and can be viewed here.

Please share this with colleagues who do not have access to the IUJ.

TRANSLATION/VALIDATION OF THE PISQ-IR

Following completion of the validation of the PISQ-IR in English, IUGA members were solicited to translate and validate the PISQ-IR in other languages. A similar protocol to that used for the English version was drafted, and sent to the potential translators, along with instructions for translation.

Once completed, IUGA will endorse translations, which follow the official protocol. Validated translations will be posted and available for use on the IUGA website. Investigators are also strongly encouraged to submit their translation/validation research for publication in the International Urogynecology Journal.


At this time, validation of the translation of the PISQ-IR is ongoing for the following languages:

Country Language

Spain

Spanish

Mexico

Spanish

Japan

Japanese

Portugal

Portuguese

Brazil

Portuguese

Thailand

Thai

Turkey

Turkish

Saudi Arabia

Arabic

USA

Arabic

Greece

Greek

Taiwan

Chinese

Russia

Russian

Poland

Polish

Country

Language

Hong Kong

Chinese

France

French

Flandes-Belgium

Flemish

Austria

German

Netherlands

Dutch

Czech Republic

Czech

Israel

Hebrew

Italy

Italian

Germany

German

Pakistan

Urdu

Denmark

Danish

Serbia

Serbian


If you are interested in translating the PISQ-IR in another language, please contact the PISQ-IR coordinator
for further information and necessary documents, at
pisq-ir@iuga.org

International Data Pool
Future international data collection (for the largest international data pool of such data) has been one of the future goals of this project. The purpose primarily is to set standards and norms within the specialty based on data collected internationally, as well as develop a short form of the PISQ-IR. Additionally the international data may be used for research purposes via application to the Research and Development Committee of IUGA.

We invite English version users and translators to participate in an international data base for the PISQ-IR through Todd Rockwood and Melissa Constantine at the University of Minnesota, USA.  This data pool will allow for the development of the normal scores for the PISQ-IR, and will be available for use for research purposes through application through the IUGA PISQ-IR research team.  Please contact Todd Rockwood at   rockw001@umn.edu  for more information.

Data Input/Scoring Instrument
The Excel file is provided here for users of the PISQ-IR to assist in the data entry/storage and scoring (available for use in all languages).


MULTICENTER VALIDATION STUDY

Publication of the manuscripts resulting from the Roundtable was followed by a multicenter study designed by Rebecca Rogers of the University of New Mexico and Todd Rockwood and Melissa Constantine, of the University of Minnesota, to validate the revised PISQ, in English (American/British). The validation process was recently completed. The results were presented at the IUGA annual meeting in Brisbane, Australia in September 2012, as an oral presentation, introducing the validated English-version PISQ-IR.

Following the oral presentation, a manuscript was completed and submitted to the International Urogynecological Journal. The published PISQ-IR is available for use and can be accessed through this link: http://link.springer.com/article/10.1007/s00192-012-2020-8

QUESTIONNAIRE


Participating Centers in the Validation Study

U.S. Sites
Rebecca Rogers, M.D.
University of New Mexico Health Sciences Center
Albuquerque, NM USA

Dorothy Kammerer-Doak, M.D.
Women’s Pelvic Specialty Care PC
Albuquerque, NM USA

G. Willy Davila, M.D.
Cleveland Clinic Florida
Department of Gynecology, Section of Urogynecology
Weston, FL USA

Mitesh Parekh, M.D.
Prime Care of SE Ohio
Genessis Health System
Zanesville, OH USA

Peter Sand, M.D.
Evanston Continence Center, Evanston Hospital
Northwestern University, Feinberg School of Medicine
Evanston, IL USA

Beri M. Ridgeway, MD

Center of Urogynecology and Reconstructive Pelvic Surgery
Obstetrics, Gynecology & Women's Health Institute
Cleveland Clinic
Cleveland, OH USA

Rachel Pauls, M.D.

Division of Urogynecology and Reconstructive Pelvic Surgery
Center for Female Sexual Health
Good Samaritan Hospital
Cincinatti, OH USA

Emily (Mimi) S. Lukacz, M.D.

UCSD Dept. Reproductive Medicine
La Jolla, CA USA

Suzette E. Sutherland, M.D.

Metro Urology
Cornerstone Medical Specialty Center
Woodbury, CT

U.K. Sites
Ranee Thakar, M.D.
Mayday University Hospital
Surrey, UK

Claudine Domoney, M.D.
Chelsea and Westminster Hospital
London, UK

Joan Pitkin, M.D.
Northwick Park & St Marks Hospital
Middlesex UK

Fiona Reid, M.D.
The Warrell Unit, Whitworth Park
St. Mary's Hospital
Manchester, UK

Swati Jha, M.D.
Royal Hallamshire Hospital
Sheffield Teaching Hospitals NHS Foundation Trust
Sheffield, UK

The final validated PISQ-IR will be available at this webpage once it is published.


IUJ SUPPLEMENT – MANUSCRIPTS RESULTING FROM THE ROUNDTABLE

The manuscripts published in a supplement of the International Urogynecology Journal in 2009 [IUJ 2009 20(supplement 1)] represented the presentations and discussions, which took place during this Roundtable retreat. They were designed to help meet the primary and secondary goals of the Roundtable.

http://www.springerlink.com/content/y742333tx3257242/



SEXUAL FUNCTION IN WOMEN - BACKGROUND INFORMATION

Sexual Dysfunctions, Female: Sexual problems are not always easy to define. How do you know if you have a sexual problem? Perhaps the clearest definition of a sexual problem is: dissatisfaction with any persistent aspect of your sexual performance, sensation, or satisfaction at any stage during the sex act (assuming you really care for your partner)”
Dr. Ruth Westheimer: Dr. Ruth’s Encyclopedia of Sex
_____________________________

Normality of sexual function in women is indeed difficult to define. This is especially true and challenging in the absence of functional normality in other intimately-associated body structures such the lower urinary and intestinal tracts and anatomic alterations such as genital prolapse. Based on the absence of a simple instrument which can be used clinically to assess individual satisfaction and bother relative to sexual function, the IUGA Research & Development Committee decided to initiate a project to better define an assessment instrument for sexual dysfunction in women in 2005 by forming a Sexual Dysfunction and the Pelvic Floor sub-committee. This sub-committee promptly realized that although there was agreement in terms of the definitions and classifications of female sexual dysfunction (FSD), there was not a universally accepted assessment instrument or questionnaire for FSD in urogynecologic patients. This is particularly true when the degree of bother or distress caused by a problem in a particular facet of sexual function is to be assessed. The importance of assessing individual impact has been emphasized by recent prevalence estimates that have concluded that although sexual problems in women occur frequently (43%), a much smaller percentage are actually distressed by their sexual problems (22.2%).

Multiple questionnaires already exist to assess sexual function, but none measure impact as a source of distress or bother to the individual suffering from urogynecologic problems. Thus, the committee opted to develop an instrument incorporating assessment of impact / bother on the individual patient. After a broad review of the literature and existing validated instruments, the committee concluded that there was not an instrument that included an assessment of impact/ bother within the framework of common pelvic floor problems such as urinary incontinence, pelvic organ prolapse and fecal incontinence.

Over the next two years, the committee held multiple meetings and reviewed multiple proposals from its members to develop an IUGA sexual dysfunction questionnaire. It eventually became clear that this goal is more complex than can be accomplished through a series of annual meetings and teleconferences. As a result, a Roundtable Discussion on sexual dysfunction in urogynecologic patients was held at the IUGA 2007 meeting in Cancun, Mexico where these issues were openly discussed by a series of experts and opened to discussion with the membership. It became clear that the membership was indeed very interested in having an effective and simple instrument that could be used in the clinical and research realms for the assessment of sexual function in women. In particular, the identification and quantification of pain associated with sexual activity was deemed to deserve clear emphasis, especially during this phase of expansion of surgical reconstructive techniques including the usage of reconstructive meshes.

During a teleconference in November 2007, a proposal was made to convene a 2–3 day roundtable session, inviting experts in sexual function assessment, questionnaire development and validation, sex therapists, urogynecologists, and other specialists in order to attempt to meet the sub-committee’s goal in a more structured session during which the entire focus would be on the development of this instrument – and its required construct and validation.

Previous work by the IUGA Research & Developments Committee has proven that this committee can in fact produce documents of use in the Urogynecological clinical and research realms. Completed projects have included a survey of urogynecologic clinical practice patterns and proposed outcome measures in stress incontinence surgery. This Committee is thus uniquely positioned to take on the challenge at hand. This received full support from IUGA’s Executive Committee. The Roundtable was held June 6-8, 2008, in Fort Lauderdale, Florida.


Goals of the Roundtable Retreat



Primary:
Develop an evaluation tool which can be used clinically as well as in urogynecologic research for assessment of female sexual function (FSF), as related to female pelvic floor conditions.

Secondary:
  1. Define the role of the urogynecologist in detecting female sexual disorders.
  2. Review the current status of FSF assessment in urogynecology, emphasizing strengths and shortcomings.
  3. Understand current needs in FSF assessment in urogynecological clinical practice and research world-wide
  4. Determine factors and variables to be considered in developing a comprehensive FSF assessment tool.
  5. Evaluate types of instruments currently available for clinical and research assessment of FSF and similar clinical conditions.
  6. Develop a plan for fine tuning and validating the instrument proposed during this Round table.

These goals were considered to be achievable and were designed to bring the developed instrument through its validation process in the English language. Subsequent translations with appropriate validation were planned in order to allow for international use of the developed instrument.

Participants were invited based on their recognized expertise and previous clinical and academic work in the areas of female sexual function, urogynecology, and outcomes research. Many were long-term IUGA members, while many were newly introduced to IUGA during this Roundtable. Some participants were themselves developers of validated FSF and FSD assessment instruments. Their participation and sharing of experiences/insights was thus particularly valuable. IUGA thanks all the participants for their contributions.

View the attendees of Sexual Dysfunction Roundtable and final program here. Final Program

Questions? CONTACT THE PISQ-IR COORDINATOR AT pisq-ir@iuga.org