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The Brazilian Portuguese version of the ICIQ-FLUTSsex: cross-cultural adaptation and measurement property analysis

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Abstract

Introduction and hypothesis

The worldwide prevalence of sexual dysfunction in women is high; therefore, an adequate assessment of this condition is necessary, with instruments validated for the Brazilian population. The aim was to translate and adapt the International Consultation on Incontinence Questionnaire Female Sexual Matters Associated with Lower Urinary Tract Symptoms into Brazilian Portuguese (ICIQ-FLUTSsex-Br) and analyze its measurement properties.

Methods

We recruited Brazilian women, literate, over 18 years old, who had had sexual intercourse in the last 4 weeks and had urinary loss. The translation and cross-cultural adaptation were performed following five stages: translation, synthesis, back translation, expert committee review, and pre-test. Measurement properties were analyzed using SPSS software, as follows: test–retest reliability using the intraclass correlation coefficient (ICC); construct validity using Pearson's correlation coefficient, by correlating the ICIQ-FLUTSsex-Br with the Female Sexual Function Index (FSFI) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12).

Results

A total of 328 women participated in the study. The reproducibility was 0.88, the standard error of measurement was 0.29, and the minimal detectable change was 0.80 (95% CI). Moderate correlations were found between the total scores of the ICIQ-FLUTSsex and PISQ-12 questionnaires (0.54, p<0.01), confirming the hypotheses outlined. Weak correlations were also found for comparisons between the FSFI and ICIQ-FLUTSsex total scores (−0.56, p<0.01) and the PISQ-12 question about fear of incontinence hindering sexual intercourse (0.26, p<0.01).

Conclusion

The Portuguese-language version of the ICIQ-FLUTSsex-Br showed validity and reproducibility, making it a tool to be used in research and clinical practice by health professionals in Brazil.

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References

  1. Masters WH, Johnson VE. The sexual response cycle of the human female. III. The clitoris: anatomic and clinical consideration. West J Surg Obstet Gynecol. 1962;70:248–57.

    CAS  PubMed  Google Scholar 

  2. Mallory AB, Stanton AM, Handy AB. Couples' sexual communication and dimensions of sexual function: a meta-analysis. J Sex Res. 2019;56:882–98. https://doi.org/10.1080/00224499.2019.1568375.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Murtagh J. Female sexual function, dysfunction, and pregnancy: implications for practice. J Midwifery Womens Health. 2010;55:438–46. https://doi.org/10.1016/j.jmwh.2009.12.006.

    Article  PubMed  Google Scholar 

  4. Chen CH, Lin YC, Chiu LH, et al. Female sexual dysfunction: definition, classification, and debates. Taiwan J Obstet Gynecol. 2013;52:3–7. https://doi.org/10.1016/j.tjog.2013.01.002.

    Article  PubMed  Google Scholar 

  5. Hayes RD, Dennerstein L, Bennett CM, et al. What is the “true” prevalence of female sexual dysfunctions and does the way we assess these conditions have an impact? J Sexual Med. 2008;5:777–87. https://doi.org/10.1111/j.1743-6109.2007.00768.x.

    Article  Google Scholar 

  6. Lewis RW. Epidemiology of sexual dysfunction in Asia compared to the rest of the world. Asian J Androl. 2011;13:152–8. https://doi.org/10.1038/aja.2010.108.

    Article  PubMed  Google Scholar 

  7. Wolpe Raquel E, Kamilla Z, Silva Fabiana P, et al. Prevalence of female sexual dysfunction in Brazil: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2017;211:26–32. https://doi.org/10.1016/j.ejogrb.2017.01.018.

    Article  CAS  PubMed  Google Scholar 

  8. Ferreira ALCG, Souza AI, Amorim MMR. Prevalência das disfunções sexuais femininas em clínica de planejamento familiar de um hospital escola no Recife, Pernambuco. Rev Bras Saude Mater Infant. 2007;7:143–50. https://doi.org/10.1590/S1519-38292007000200004.

    Article  Google Scholar 

  9. Lima AC, Dotto LM, Mamede MV. Prevalence of sexual dysfunction in primigravidae in Rio Branco, Acre State. Brazil. Cad Saude Publica. 2013;29:1544–54. https://doi.org/10.1590/0102-311x00164012.

    Article  PubMed  Google Scholar 

  10. Cabral PU, Canário AC, Spyrides MH, et al. Determinants of sexual dysfunction among middle-aged women. Int J Gynaecol Obstet. 2013;120:271–4. https://doi.org/10.1016/j.ijgo.2012.09.023.

    Article  PubMed  Google Scholar 

  11. Magno LDP. Avaliação quantitativa da função sexual feminina correlacionada com a contração dos músculos do assoalho pélvico. Rev Pan-Amaz Saude. 2011;2:39–46. https://doi.org/10.5123/S2176-62232011000400006.

    Article  Google Scholar 

  12. Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29:4–20. https://doi.org/10.1007/s00192-009-0976-9.

    Article  PubMed  Google Scholar 

  13. Potter J. Female sexuality: assessing satisfaction and addressing problems. ACP Medicine. 2009;1–23.http://what-when-how.com/acp-medicine/female-sexuality-assessing-satisfaction-and-addressing-problems-part-1/.

  14. Price N, Jackson S, Avery K, et al. Development and psychometric evaluation of the ICIQ Vaginal Symptoms Questionnaire: the ICIQ-VS. BJOG. 2006;113:700–12. https://doi.org/10.1111/j.1471-0528.2006.00938.x.

    Article  CAS  PubMed  Google Scholar 

  15. International Consultation on Incontinence Questionnaire. Female Sexual Matters Associated with Lower Urinary Tract Symptoms Module. Available: http://iciq.net/iciq-flutssex.

  16. Uren AD, Cotterill N, Pardoe M, et al. The International Consultation on Incontinence Questionnaires (ICIQ): an update on status and direction. Neurourol Urodyn. 2020;39:1–8. https://doi.org/10.1002/nau.24437.

    Article  Google Scholar 

  17. International Consultation on Incontinence Questionnaire. ICIQ Validation Methodology. Available: http://iciq.net/validation-ethodology.

  18. Beaton DE, Bombardier C, Guillemin F, et al. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25:3186–91. https://doi.org/10.1097/00007632-200012150-00014.

    Article  CAS  PubMed  Google Scholar 

  19. Mokkink LB, Terwee CB, Patrick DL, et al. COSMIN Checklist Manual. EMGO Institute for Health and Care Research, ed. 2012.

  20. Hentschel H, Alberton DL, Capp E, et al. Validation of the Female Sexual Function Index (FSFI) for Portuguese language. Clin Biomed Res. 2007;27:10–4. Available: https://seer.ufrgs.br/hcpa/article/view/471

    Google Scholar 

  21. Brusaca LA, Rocha APR, Cardozo L, et al. Brazilian version of the King's Health Questionnaire: assessment of the structural validity and internal consistency in female urinary incontinence. Int Urogynecol J. 2022;33:3143–54. https://doi.org/10.1007/s00192-022-05189-3.

    Article  PubMed  Google Scholar 

  22. Santana GWRM, Aoki T, Auge APF. The Portuguese validation of the short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire (PISQ-12). Int Urogynecol J. 2012;23:117–21. https://doi.org/10.1007/s00192-011-1505-1.

    Article  PubMed  Google Scholar 

  23. Epstein J, Santo RM, Guillemin F. A review of guidelines for cross-cultural adaptation of questionnaires could not bring out a consensus. J Clin Epidemiol. 2015;68:435–41. https://doi.org/10.1016/j.jclinepi.2014.11.021.

    Article  PubMed  Google Scholar 

  24. MOKKINK, Lidwine B. et al. COSMIN risk of bias tool to assess the quality of studies on reliability and measurement error of outcome measurement instrument. User Manual Version. 2021. Available: https://www.cosmin.nl/wp-content/uploads/user-manual-COSMIN-Risk-of-Bias-tool_v4_JAN_final.pdf

  25. Armijo-Olivo S, de Castro-Carletti EM, Calixtre LB, et al. Understanding clinical significance in rehabilitation: a primer for researchers and clinicians. Am J Phys Med Rehabil. 2022;101(1):64–77. https://doi.org/10.1097/PHM.0000000000001799.

    Article  PubMed  Google Scholar 

  26. Mokkink LB, Terwee CB, Knol DL, et al. Protocol of the COSMIN study: COnsensus-based Standards for the selection of health Measurement Instruments. BMC Med Res Methodol. 2006;6:1–7. https://doi.org/10.1186/1471-2288-6-2.

    Article  Google Scholar 

  27. Souza AC, Alexandre NMC, Guirardello EB. Psychometric properties in instruments evaluation of reliability and validity. Epidemiol Serv Saude. 2017;26:649–59. https://doi.org/10.5123/S1679-49742017000300022.

    Article  PubMed  Google Scholar 

  28. Koo TK, Li MY. A guideline of guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropractic Med. 2016;15:155–63. https://doi.org/10.1016/j.jcm.2016.02.012.

    Article  Google Scholar 

  29. Terwee CB, Bot SD, de Boer MR, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60:34–42. https://doi.org/10.1016/j.jclinepi.2006.03.012.

    Article  PubMed  Google Scholar 

  30. Gungor Uğurlucan F, Yasa C, Yuksel Ozgor B, et al. Validation of the Turkish version of the ICIQ-FLUTS, ICIQ-FLUTS long-form, ICIQ-LUTS quality-of-life, and ICIQ-FLUTS sexual functions. Neurourol Urodyn. 2020;39:962–8. https://doi.org/10.1002/nau.24302.

    Article  PubMed  Google Scholar 

  31. Mokkink LB, Prinsen CAC, Patrick DL, et al. COSMIN methodology for systematic reviews of Patient-Reported Outcome Measures (PROMs). Amsterdam: 2017; p. 1–80. Available: https://cosmin.nl/wp-content/uploads/COSMIN_manual_syst-review-PROMs_V1.0.pdf

  32. Mokkink LB, Prinsen CAC, Patrick DL, et al. COSMIN study design checklist for patient-reported outcome measurement instruments. Amsterdam: COSMIN. 2019; p. 1–32. https://www.cosmin.nl/wp-content/uploads/COSMIN-study-designing-checklist_final.pdf

  33. Horowitz AD, Bedford E. Graded structure in sexual definitions: categorizations of having “had sex” and virginity loss among homosexual and heterosexual men and women. Arch Sex Behav. 2017;46:1653–65. https://doi.org/10.1007/s10508-016-0905-1.

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors thank the participants of this study for making its development possible as well as the Fundação de Amparo à Pesquisa do Estado de São Paulo-FAPESP (Process 2019/14666-7) for funding the study. In addition, to the University Hospital of UFSCar managed by the Brazilian Company of Hospital Services (EBSERH), for the authorization for data collection and the Federal University of São Carlos (UFSCar) for the support in carrying out the study. Finally, I thank the researcher, Guilherme Arruda Tavares for the guidance regarding the statistical analysis of this study.

Funding

This study was funded by the São Paulo State Research Support Foundation (FAPESP) under process 2019/14666-7, the authors declare that the funding agency did not interfere in the study design, data collection and analysis, manuscript writing, or publication decision.

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Authors and Affiliations

  1. Federal University of Sao Carlos (UFSCar) – Sao Carlos, Rod. Washington Luís km 235, Sao Carlos, SP-310, Brazil

    Clara Maria de Araujo Silva, Patricia Driusso, Giovana Garçoni Poli, Michele Garcia Venancio, Roberta de Fátima Carreira Moreira Padovez & Ana Carolina Sartorato Beleza

  2. Oeste Paulista University (UNOESTE), Jaú, Sao Paulo, Brazil

    Amanda Magdalena Feroldi Fabricio

  3. Ribeirao Preto Medical School - University of Sao Paulo (FMRP-USP), Ribeirao Preto, Sao Paulo, Brazil

    Cristine Homsi Jorge

Authors
  1. Clara Maria de Araujo Silva
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  2. Patricia Driusso
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  3. Giovana Garçoni Poli
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  4. Amanda Magdalena Feroldi Fabricio
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  7. Roberta de Fátima Carreira Moreira Padovez
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  8. Ana Carolina Sartorato Beleza
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Contributions

C.M.A. Silva: project development, data collection, manuscript writing; P. Driusso: project development, formal analysis, manuscript review; G.G. Poli: project development, data collection, manuscript writing; A.M.F. Fabricio: project development, data collection; M.G. Venancio: project development, data collection; C.H. Jorge: project development, manuscript review; R.F.C.M. Padovez: project development, manuscript review; A.C.S. Beleza: project development, manuscript writing and review.

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Correspondence to Ana Carolina Sartorato Beleza.

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de Araujo Silva, C.M., Driusso, P., Poli, G.G. et al. The Brazilian Portuguese version of the ICIQ-FLUTSsex: cross-cultural adaptation and measurement property analysis. Int Urogynecol J 34, 2547–2555 (2023). https://doi.org/10.1007/s00192-023-05563-9

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