Patient-Reported Outcome Measures (PROMs) in Pelvic Floor Disorders

  • Engy HabashyEmail author
  • Ayman E. Mahdy
Female Urology (L Cox, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Female Urology


Purpose of Review

Patient-reported outcome measures (PROMs) are tools that are widely used by clinicians and researchers across different medical specialties. In this review, we examine the use of PROMs in the evaluation of female pelvic floor disorders (PFD).

Recent Findings

PROM development in the assessment of urinary incontinence is more advanced than other pelvic disorders. Work is ongoing in the scientific community to improve currently available measures and create new robust tools where needed.


Hundreds of PROMs are available for use in the evaluation of PFD, some more rigorously validated than others. They are used to screen for diseases, evaluate their impact on quality of life, determine the results of treatment, and measure patient’s satisfaction with treatment. Careful consideration is required to choose the appropriate PROMs to care for a patient or include in a research study. The topic was reviewed in the Textbook of Female Urology and Urogynecology published in 2017. We reviewed recent literature (2015–2018) on the topic and summarized our findings.


Pelvic floor disorders Patient-reported outcomes Female sexual dysfunction Urge incontinence Fecal incontinence Pelvic organ prolapse 


Compliance with Ethical Standards

Conflict of Interest

Engy Habashy and Ayman E. Mahdy each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.
    Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008;300(11):1311–6. Scholar
  2. 2.
    Jundt K, Peschers U, Kentenich H. The investigation and treatment of female pelvic floor dysfunction. Dtsch Arztebl Int. 2015;112(33–34):564–74. Scholar
  3. 3.
    Weldring T, Smith SM. Patient-Reported Outcomes (PROs) and Patient-Reported Outcome Measures (PROMs). Health Serv Insights. 2013;6:61–8. Scholar
  4. 4.
    Cella D, Yount S, Rothrock N, Gershon R, Cook K, Reeve B, et al. The Patient-Reported Outcomes Measurement Information System (PROMIS): progress of an NIH Roadmap cooperative group during its first two years. Med Care. 2007;45(5 Suppl 1):S3–S11. Scholar
  5. 5.
    Black N. Patient reported outcome measures could help transform healthcare. BMJ. 2013;346:f167. Scholar
  6. 6.
    Coyne K, Sexton C. Patient-reported outcomes: from development to utilization. In: Cardozo L, Staskin D, editors. Textbook of female urology and urogynecology. Fourth ed. Boca Raton: CRC press/ Taylor & Francis Group; 2017.Google Scholar
  7. 7.
    Association AP. Diagnostic and Statistical manual of mental disorders: DSM- 5. 5th ed. Washington, D.C.: American Psychiatric Association; 2013.CrossRefGoogle Scholar
  8. 8.
    Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol. 2008;112(5):970–8. Scholar
  9. 9.
    Hayes RD, Bennett CM, Fairley CK, Dennerstein L. What can prevalence studies tell us about female sexual difficulty and dysfunction? J Sex Med. 2006;3(4):589–95. Scholar
  10. 10.
    Wright JJ, O’Connor KM. Female sexual dysfunction. Med Clin North Am. 2015;99(3):607–28. Scholar
  11. 11.
    Hatzichristou D, Kirana PS, Banner L, Althof SE, Lonnee-Hoffmann RA, Dennerstein L, et al. Diagnosing sexual dysfunction in men and women: sexual history taking and the role of symptom scales and questionnaires. J Sex Med. 2016;13(8):1166–82. Scholar
  12. 12.
    • Domoney C, Symonds T. Questionnaires to assess sexual function. In: Cardozo L, Staskin D, editors. Textbook of female urology and urogynecology. Fourth ed. Boca Raton: CRC Press/Taylor & Francis Group; 2017. Updated review of questionnaires assessing sexual function. Google Scholar
  13. 13.
    Frost R, Donovan C. The development and validation of the sexual and relationship distress scale. J Sex Med. 2018;15(8):1167–79. Scholar
  14. 14.
    Derogatis LR, Rosen R, Leiblum S, Burnett A, Heiman J. The Female Sexual Distress Scale (FSDS): initial validation of a standardized scale for assessment of sexually related personal distress in women. J Sex Marital Ther. 2002;28(4):317–30.CrossRefGoogle Scholar
  15. 15.
    Li-Yun-Fong RJ, Larouche M, Hyakutake M, Koenig N, Lovatt C, Geoffrion R, et al. Is pelvic floor dysfunction an independent threat to sexual function? A cross-sectional study in women with pelvic floor dysfunction. J Sex Med. 2017;14(2):226–37. Scholar
  16. 16.
    Dennerstein L, Anderson-Hunt M, Dudley E. Evaluation of a short scale to assess female sexual functioning. J Sex Marital Ther. 2002;28(5):389–97.CrossRefGoogle Scholar
  17. 17.
    Flynn KE, Lin L, Bruner DW, Cyranowski JM, Hahn EA, Jeffery DD, et al. Sexual satisfaction and the importance of sexual health to quality of life throughout the life course of U.S. adults. J Sex Med. 2016;13(11):1642–50. Scholar
  18. 18.
    Weinfurt KP, Lin L, Bruner DW, Cyranowski JM, Dombeck CB, Hahn EA, et al. Development and initial validation of the PROMIS(®) sexual function and satisfaction measures version 2.0. J Sex Med. 2015;12(9):1961–74. Scholar
  19. 19.
    Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2003;61(1):37–49.CrossRefGoogle Scholar
  20. 20.
    • Cotterill N, Abrams P. International Consultation on Incontinence Modular Questionnaire. In: Cardozo L, Staskin D, editors. Textbook of female urology and urogynecology. Fourth ed. Boca Raton: CRC Press/Taylor & Francis Group; 2017. Evolution and detailed review of the International Consultation on Incontinence Modular Questionnaire. Google Scholar
  21. 21.
    Yearwood Martin C, Murphy C, Cotterill N, Williams S, Cottenden A, Fader M. Development and psychometric evaluation of ICIQ-PadPROM: a quality of life questionnaire to assess the treatment effect of absorbent continence products. Neurourol Urodyn. 2018;37(5):1650–7. Scholar
  22. 22.
    Nyström E, Sjöström M, Stenlund H, Samuelsson E. ICIQ symptom and quality of life instruments measure clinically relevant improvements in women with stress urinary incontinence. Neurourol Urodyn. 2015;34(8):747–51. Scholar
  23. 23.
    Karmakar D, Mostafa A, Abdel-Fattah M. A new validated score for detecting patient-reported success on postoperative ICIQ-SF: a novel two-stage analysis from two large RCT cohorts. Int Urogynecol J. 2017;28(1):95–100. Scholar
  24. 24.
    Jelovsek JE, Barber MD, Paraiso MF, Walters MD. Functional bowel and anorectal disorders in patients with pelvic organ prolapse and incontinence. Am J Obstet Gynecol. 2005;193(6):2105–11. Scholar
  25. 25.
    • Mohamed S, Chatoor D, Williams A. Questionnaires to assess bowel function. In: Cardozo L, Staskin D, editors. Textbook of female urology and urogynecology. Fourth ed. Boca Raton: CRC Press/Taylor & Francis Group; 2017. Review of questionnaires used to assess bowel function. Google Scholar
  26. 26.
    Cotterill N, Norton C, Avery KN, Abrams P, Donovan JL. Psychometric evaluation of a new patient-completed questionnaire for evaluating anal incontinence symptoms and impact on quality of life: the ICIQ-B. Dis Colon Rectum. 2011;54(10):1235–50. Scholar
  27. 27.
    Marquis P, De La Loge C, Dubois D, McDermott A, Chassany O. Development and validation of the Patient Assessment of Constipation Quality of Life questionnaire. Scand J Gastroenterol. 2005;40(5):540–51. Scholar
  28. 28.
    Bordeianou L, Hicks CW, Olariu A, Savitt L, Pulliam SJ, Weinstein M, et al. Effect of coexisting pelvic floor disorders on fecal incontinence quality of life scores: a prospective, survey-based study. Dis Colon Rectum. 2015;58(11):1091–7. Scholar
  29. 29.
    Persu C, Chapple CR, Cauni V, Gutue S, Geavlete P. Pelvic Organ Prolapse Quantification System (POP-Q) - a new era in pelvic prolapse staging. J Med Life. 2011;4(1):75–81.PubMedPubMedCentralGoogle Scholar
  30. 30.
    Barber MD, Maher C. Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J. 2013;24(11):1783–90. Scholar
  31. 31.
    Jelovsek JE, Maher C, Barber MD. Pelvic organ prolapse. Lancet. 2007;369(9566):1027–38. Scholar
  32. 32.
    • Disgesu A. Questionnaires to assess pelvic organ prolapse. In: Cardozo L, Staskin D, editors. Textbook of female urology and urogynecology. Fourth ed. Boca Raton: CRC Press/Taylor & Francis Group; 2017. Review of questionnaires currently available to assess patients with pelvic organ prolapse. Google Scholar
  33. 33.
    Bradley CS, Nygaard IE. Vaginal wall descensus and pelvic floor symptoms in older women. Obstet Gynecol. 2005;106(4):759–66. Scholar
  34. 34.
    Balchandra P, Marsh F, Landon C. Perioperative outcomes and prospective patient reported outcome measures for transvaginal mesh surgery. Arch Gynecol Obstet. 2015;292(4):875–82. Scholar
  35. 35.
    Price N, Jackson SR, Avery K, Brookes ST, Abrams P. Development and psychometric evaluation of the ICIQ vaginal symptoms questionnaire: the ICIQ-VS. BJOG. 2006;113(6):700–12. Scholar
  36. 36.
    Bradley CS, Visco AG, Weber LeBrun EE, Barber MD. The pelvic floor disorders registry: purpose and development. Female Pelvic Med Reconstr Surg. 2016;22(2):77–82. Scholar
  37. 37.
    Weber LeBrun E, Adam RA, Barber MD, Boyles SH, Iglesia CB, Lukacz ES, et al. Pelvic floor disorders registry: study design and outcome measures. Female Pelvic Med Reconstr Surg. 2016;22(2):70–6. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Surgery, Division of UrologyUniversity of CincinnatiCincinnatiUSA

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