International Urogynecology Journal

, Volume 24, Issue 7, pp 1105–1122 | Cite as

The PISQ-IR: considerations in scale scoring and development

  • Todd H. RockwoodEmail author
  • Melissa L. Constantine
  • Olusola Adegoke
  • Rebecca G. Rogers
  • Elektra McDermott
  • G. Willy Davila
  • Claudine Domoney
  • Swati Jha
  • Dorothy Kammerer-Doak
  • Emily S. Lukacz
  • Mitesh Parekh
  • Rachel Pauls
  • Joan Pitkin
  • Fiona Reid
  • Beri Ridgeway
  • Ranee Thakar
  • Peter K. Sand
  • Suzette E. Sutherland
  • Montserrat Espuna-Pons
Original Article



This paper provides a detailed discussion of the psychometric analysis and scoring of a revised measure of sexual function in women with pelvic floor disorders (PFD): the Pelvic Organ Prolapse Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR).


Standard tools for evaluating item distributions, relationships, and psychometric properties were used to identify sub-scales and determine how the sub-scales should be scored. The evaluation of items included a nonresponse analysis, the nature of missingness, and imputation methods. The minimum number of items required to be answered and three different scoring methods were evaluated: simple summation, mean calculation, and transformed summation.


Item nonresponse levels are low in women who are sexually active and the psychometric properties of the scales are robust. Moderate levels of item nonresponse are present for women who are not sexually active, which presents some concerns relative to the robustness of the scales. Single imputation for missing items is not advisable and multiple imputation methods, while plausible, are not recommended owing to the complexity of their application in clinical research. The sub-scales can be scored using either mean calculation or transformed summation. Calculation of a summary score is not recommended.


The PISQ-IR demonstrates strong psychometric properties in women who are sexually active and acceptable properties in those who are not sexually active. To score the PISQ-IR sub-scales, half of the items must be answered, imputation is not recommended, and either mean calculation or transformed sum methods are recommended. A summary score should not be calculated.


Sexual function questionnaire Pelvic organ prolapse Urinary incontinence Anal incontinence Psychometric analysis Scale development 



This study was reviewed and approved by the University of Minnesota IRB #0908 M70626. This study was funded by the International Urogynecological Association. University of Minnesota, Grant Award Number CON000000021500, Todd H Rockwood, PhD, PI.

Conflict of interest



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Copyright information

© The International Urogynecological Association 2013

Authors and Affiliations

  • Todd H. Rockwood
    • 1
    Email author
  • Melissa L. Constantine
    • 2
  • Olusola Adegoke
    • 3
  • Rebecca G. Rogers
    • 4
  • Elektra McDermott
    • 5
  • G. Willy Davila
    • 6
  • Claudine Domoney
    • 7
  • Swati Jha
    • 8
  • Dorothy Kammerer-Doak
    • 9
  • Emily S. Lukacz
    • 10
  • Mitesh Parekh
    • 11
  • Rachel Pauls
    • 12
  • Joan Pitkin
    • 13
  • Fiona Reid
    • 14
  • Beri Ridgeway
    • 15
  • Ranee Thakar
    • 16
  • Peter K. Sand
    • 17
  • Suzette E. Sutherland
    • 18
  • Montserrat Espuna-Pons
    • 19
  1. 1.Division of Health Policy and ManagementUniversity of MinnesotaMinneapolisUSA
  2. 2.Center for Bioethics and Social Sciences in MedicineUniversity of Michigan Medical SchoolAnn ArborUSA
  3. 3.Health Economics DivisionUCareMinneapolisUSA
  4. 4.Division of UrogynecologyUniversity of New Mexico Health Sciences CenterAlbuquerqueUSA
  5. 5.Educational Programs, International Urogynecological AssociationFort LauderdaleUSA
  6. 6.Cleveland Clinic Florida, Department of Gynecology, Section of UrogynecologyWestonUSA
  7. 7.Chelsea and Westminster HospitalLondonUK
  8. 8.Department of UrogynaecologyRoyal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation TrustSheffieldUK
  9. 9.Women’s Pelvic Specialty CareAlbuquerqueUSA
  10. 10.UC San Diego Health SystemSan DiegoUSA
  11. 11.Medical Director, UrogynecologyGenesis Health SystemZanesvilleUSA
  12. 12.Division of Urogynecology and Reconstructive Pelvic SurgeryGood Samaritan HospitalCincinnatiUSA
  13. 13.Northwick Park & St Marks HospitalMiddlesexUK
  14. 14.The Warrell UnitWhitworth ParkUK
  15. 15.Cleveland ClinicClevelandUSA
  16. 16.Croydon University HospitalSurreyUK
  17. 17.Evanston Continence CenterUniversity of Chicago, Pritzker School of MedicineEvanstonUSA
  18. 18.Center for Continence Care and Female UrologyMetro UrologyMinneapolisUSA
  19. 19.ICGON Hospital ClinicUniversity of BarcelonaBarcelonaSpain

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