Responsiveness of Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire-7 after pelvic floor muscle training and surgical treatment

Introduction: Urinary incontinence (UI) and pelvic organ prolapse (POP) significantly impair quality of life (QoL). Pelvic floor muscle training (PFMT) is the first-line intervention. This study aims to evaluate the responsiveness of the Chinese version of Urogenital Distress Inventory-6 (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7) after PFMT and surgical treatment in women with UI and/or POP. Methods: Between April 2017 and December 2018, women who were referred to our urogynaecology clinic to undergo PFMT and/or surgery for UI and/or POP were recruited. They were instructed to perform three sets of pelvic floor muscle contractions per day. Women were followed up after 3 to 6 months. Women with moderate or severe urodynamic stress incontinence after PFMT were offered tension-free vaginal tape procedure. Women were asked to complete the UDI-6 for urinary symptoms and IIQ-7 for QoL before and after treatment. The responsiveness of UDI-6 and IIQ-7 were evaluated by effect size and standardised response mean. Results: In 452 women who received PFMT, the most common diagnosis was UI (n=318, 70.4%), followed by POP (n=47, 10.4%), and concomitant UI and POP (n=87, 19.2%). 44 women underwent tension-free vaginal tape procedure after PFMT failed. After PFMT, the UDI-6 score improved from 38.9 to 29.4 (p<0.001) and the IIQ-7 score improved from 27.1 to 19.8 (p<0.001). After tension-free vaginal tape procedure, the UDI-6 score improved from 60.3 to 22.1 (p<0.001) and the IIQ-7 score improved from 39.1 to 8.1 (p<0.001). Responsiveness to change in scores of UDI-6 and IIQ-7 was moderate and small, respectively. Conclusion: The UDI-6 and IIQ-7 are modestly responsive to change after PFMT and tension-free vaginal tape procedure in women with UI and/or POP.