International Urogynecology Journal

, Volume 24, Issue 4, pp 655–670

Spanish translation and validation of four short pelvic floor disorders questionnaires


    • Mount Sinai School of Medicine
  • Deborah Karp
    • Cleveland Clinic Florida
  • Madeline Dick-Biascoechea
    • Yale School of Medicine
  • Nazanin Ehsani
    • St. Luke’s Hospital and Health Network
  • Christina Dancz
    • Los Angeles County-University of Southern California Medical Center
  • T. Ignacio Montoya
    • University of Texas Southwestern Medical Center
  • Cedric K. Olivera
    • SUNY Downstate Medical Center
  • Aimee L. Smith
    • Cleveland Clinic Florida
  • Rosa Cardenas
    • Mount Sinai Medical Center
  • Tola Fashokun
    • Johns Hopkins University School of Medicine
  • Catherine S. Bradley
    • Iowa City VA Health Care System and Carver College of MedicineUniversity of Iowa
  • Society of Gynecologic Surgeons Fellows’ Pelvic Research Network
Original Article

DOI: 10.1007/s00192-012-1894-9

Cite this article as:
Treszezamsky, A.D., Karp, D., Dick-Biascoechea, M. et al. Int Urogynecol J (2013) 24: 655. doi:10.1007/s00192-012-1894-9


Introduction and hypothesis

Globally, Spanish is the primary language for 329 million people; however, most urogynecologic questionnaires are available in English. We set out to develop valid Spanish translations of the Questionnaire for Urinary Incontinence Diagnosis (QUID), the Three Incontinence Questions (3IQ), and the short Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7).


The TRAPD method (translation, review, adjudication, pretesting, and documentation) was used for translation. Eight native Spanish-speaking translators developed Spanish versions collaboratively. These were pretested with cognitive interviews and revised until optimal. For validation, bilingual patients at seven clinics completed Spanish and English questionnaire versions in randomized order. Participants completed a second set of questionnaires later. The Spanish versions’ internal consistency and reliability and Spanish-English agreement were measured using Cronbach’s alpha, weighted kappa, and intraclass correlation coefficients.


A total of 78 subjects were included; 94.9 % self-identified as Hispanic and 73.1 % spoke Spanish as their primary language. The proportion of per-item missing responses was similar in both languages (median 1.3 %). Internal consistency for Spanish PFDI-20 subscales was acceptable to good and for PFIQ-7 and QUID excellent. Test-retest reliability per item was moderate to near perfect for PFDI-20, substantial to near perfect for PFIQ-7 and 3IQ, and substantial for QUID. Spanish-English agreement for individual items was substantial to near perfect for all questionnaires (kappa range 0.64–0.95) and agreement for PFDI-20, PFIQ-7, and QUID subscales scores was high [intraclass correlation coefficient (ICC) range 0.92–0.99].


We obtained valid Spanish translations of the PFDI-20, PFIQ-7, QUID, and 3IQ. These results support their use as clinical and research assessment tools in Spanish-speaking populations.


3IQPFDI-20PFIQ-7QUIDSpanish translationValidation

Copyright information

© The International Urogynecological Association 2012