International Urogynecology Journal

, Volume 30, Issue 1, pp 131–137 | Cite as

Transcultural translation and validation of the FIGO Assessment Scoring System (FASS) to Portuguese language

  • Ana Eliza Rios de Araújo Mathias
  • Márcia Silva de Oliveira
  • Carolina Mayumi Haruta
  • Fábia Maria de Lima
  • Kátia Cristina Lima de Petribú
  • Geraldo de Aguiar CavalcantiEmail author
  • Steven E. Swift
  • Alessandro Digesu
Original Article


Introduction and hypothesis

Our aim was to validate the Brazilian Portuguese version of the International Federation of Gynecology and Obstetrics (FIGO) Assessment Scoring System (FASS) to identify and quantify signs and symptoms related to pelvic floor dysfunction.


One hundred and seventy-nine women aged 18–82 (47.68 ± 14.42) years participated in this validation study. Collected data included a sociodemographic and clinical questionnaire, application of the FASS, and physical examination using the Pelvic Prgan Prolapse Quantification (POP-Q) system. The translation and cross-cultural adaptation were performed following the international methodology. The psychometric properties tested were criterion validity, construct validity, stability, and reliability. For this purpose, the comparison with POP-Q findings and between symptomatic and asymptomatic patients, test–retest and internal consistency (Cronbach’s alpha) were used, respectively. The intraclass correlation coefficient (ICC) was calculated to assess the level of agreement between evaluations (inter- and intraobservers). P < 0.05 was considered statistically significant.


The calculated Cronbach’s alpha coefficient was 0.76, indicating strong reliability for the validation sample. Symptomatic women had different scores on all FASS items as well as total score when compared with asymptomatic women (p < 0.001). Intraobserver coefficient ranged from 0.91 (urinary symptoms) to 0.98 (FASS total score), indicating excellent concordance level in all items. Interobserver coefficient ranged from 0.47 (intestinal symptoms) to 0.90 (FASS total score), indicating moderate to excellent correlation.


The psychometric properties tested in the FASS Portuguese version proved to be a valid and reliable for evaluating signs and symptoms related to pelvic floor function in Brazilian women.


Validation studies Pelvic organ prolapse Psychometrics 



Body mass index


FIGO Assessment Scoring System


International Federation of Gynecology and Obstetrics


Intraclass Correlation Coefficient


International Continence Society


International Urogynecological Association


Pelvic organ prolapse


Pelvic Organ Prolapse Quantification


Quality of Life


Statistical Package for Social Sciences


Compliance with ethical standards

Conflicts of interest

AERA Mathias: None; MS Oliveira: None; CM Haruta: Speaker of the Astellas laboratories; FM Lima: None; KCL Petribú: Speaker of the Jansen and Servier; GA Cavalcanti: Speaker of the Astellas laboratories; SE Swift: None; A Digesu: None.


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Copyright information

© The International Urogynecological Association 2018

Authors and Affiliations

  • Ana Eliza Rios de Araújo Mathias
    • 1
  • Márcia Silva de Oliveira
    • 2
  • Carolina Mayumi Haruta
    • 3
  • Fábia Maria de Lima
    • 4
  • Kátia Cristina Lima de Petribú
    • 4
  • Geraldo de Aguiar Cavalcanti
    • 2
    • 4
    Email author
  • Steven E. Swift
    • 5
  • Alessandro Digesu
    • 6
  1. 1.University of Pernambuco (UPE)PetrolinaBrazil
  2. 2.Federal University of Pernambuco (UFPE)RecifeBrazil
  3. 3.Professor Fernando Figueira Integral Medicine Institute (IMIP)RecifeBrazil
  4. 4.University of Pernambuco (UPE)RecifeBrazil
  5. 5.Medical University of South Carolina (MUSC)CharlestonUSA
  6. 6.Imperial College Healthcare TrustLondonUK

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