This study was undertaken to evaluate the responsiveness of the Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) in women with
pelvic organ prolapse undergoing surgical and nonsurgical management.
STUDY DESIGN: The responsiveness of the
prolapse, urinary and colorectal scales of the PFDI and PFIQ were assessed in 2 independent populations: (1) 42 women with stage II or greater
prolapse enrolled in an ongoing multicenter randomized trial comparing 2 different
pessaries (
Pessary group) and (2) 64 women with stage III or greater
prolapse who underwent vaginal reconstructive surgery (Surgery group). All subjects completed the PFDI and PFIQ at baseline and again either 3 months (
Pessary group) or 6 months (Surgery group) after initiation of treatment. Responsiveness was assessed with standardized response mean (SRM), effect size (ES), and the paired t test.
RESULTS: In the
Pessary group, there was a significant improvement in the
prolapse and urinary scales of the PFDI, with each demonstrating moderate responsiveness (
prolapse: SRM 0.69, ES 0.68; urinary: SRM 0.57, ES: 0.50, P < .001 for each). The colorectal scale of the PFDI and each of the 3 scales of the PFIQ demonstrated no significant change in scores with
pessary use. In the Surgery group, there was a significant improvement in the
prolapse, urinary, and colorectal scales of both the PFDI and PFIQ (P < .01 for each). The
prolapse and urinary scales of the PFDI demonstrated excellent responsiveness with SRM and ES 1.20 or greater for the
prolapse scale and equal to1.05 for the urinary scales. The colorectal scale of the PFDI and the urinary and
prolapse scales of the PFIQ demonstrated moderate responsiveness (SRM 0.61-0.70 and ES 0.56-0.60) after surgery. Subjects who had a recurrence of their
prolapse develop after surgery (6%) had significantly less improvement in the
prolapse scale of the PFDI than those who did not. After controlling for preoperative
prolapse stage and baseline quality of life scores, subjects in the Surgery group had significantly greater improvement in each of the scales of the PFDI and the
prolapse and urinary scales of the PFIQ than did the
Pessary group (P < .05 for each).
CONCLUSION: