Self-Report Urinary Incontinence Questionnaire

Original Editor - Ajay Upadhyay

Top Contributors - Ajay Upadhyay, Khloud Shreif and Alexandra Stead  

Objective

Self-Report Urinary Incontinence Questionnaire (UIQ) was developed by Focus On Therapeutic Outcomes (FOTO) in collaboration with a specialised physical therapist dealing with patients with pelvic floor dysfunctions. This questionnaire was developed in response to the International Consultation on Incontinence (ICI) Scientific Committee, who suggested there was a need to develop a universally applicable and practical questionnaire to assess urinary incontinence.

This questionnaire is used to assess and evaluate patients with different levels of urinary function by using 21-item urinary incontinence questionnaire (21-UIQ) with patients seeking outpatient physical therapy services due to pelvic floor dysfunctions.

Intended Population

Outpatients with urinary symptoms (urgency, and frequency) with different ages and for both males and females.

Method of Use

The UIQ self-report questionnaire consists of 21 items: 17 related to urinary leakage problems, 2 related to frequency problems, and 2 related to retention problems, takes approximately 5-10 minutes to complete. Each item has its own Likert rating scale structure and operational definition.

Urinary Incontinence Questionnaire

Urinary Leakage Items

• How often does urine leak for no obvious reason when you are awake?

1. Never
2. Once or less per week
3. More than once a week
4. Once a day
5. Several times a day
6. Continuously

• How much urine usually leaks for no obvious reason when you are awake?

1. A few drops
2. Enough to make underpants/pads wet
3. Enough to wet outer clothes
4. Urine runs down legs onto floor

• How often does urine leak when you are asleep?

1. Never
2. Once or less per week
3. More than once a week
4. Once a day
5. Several times a day
6. Continuously

• How much urine usually leaks while you are sleeping?

1. A few drops
2. Enough to make pyjamas/pads wet
3. Enough to wet all clothes and bedding

• How often do you leak urine after you thought you had finished urinating?

1. Never
2. Once or less per week
3. More than once a week
4. Once a day
5. Several times a day
6. Every time

• How much urine usually leaks after you thought you had finished urinating?

1. A few drops
2. Enough to make underpants/pads wet
3. Enough to wet outer clothes
4. Urine runs down legs onto floor

• How often does urine leak before you can get to the toilet?

1. Never
2. Once or less per week
3. More than once a week
4. Once a day
5. Several times a day
6. Every time

• How much urine usually leaks before you can get to the toilet?

1. A few drops
2. Enough to make underpants/pads wet
3. Enough to wet outer clothes
4. Urine runs down legs onto floor

• How often does urine leak when you are physically active, including coughing or sneezing?

1. Never
2. Once or less per week
3. More than once a week
4. Once a day
5. Several times a day

• Describe the level of activity that causes urine leakage.

1. Vigorous activity, such as running, exercise, coughing, or sneezing
2. Moderate activity, such as household chores or lifting
3. Light activity, such as walking, bending, or rising
4. Leak even without activity

• How much urine usually leaks when you are physically active or coughing or sneezing?

1. A few drops
2. Enough to make underpants/pads wet
3. Enough to wet outer clothes
4. Urine runs down legs onto floor

• What type of protection do you use for your urine leakage?

1. None
2. Underpants liners or mini-pads
3. Maxi-pads
4. Incontinence pads
5. Incontinence briefs
6. Diapers

• Select the number of protective garments for urine leakage you use per day.

1. 1
2. 2
3. 3
4. 4
5. ≥5

• Overall, how much does leaking urine interfere with your life?

1. Does not interfere with my life
2. Minor inconvenience
3. Slight problem
4. Moderate problem

• To what extent do you feel your sex life has been affected by urine leakage?

1. Has not affected my sex life
2. A little
3. Somewhat
4. A great deal

• Describe your level of confidence in your ability to control your urine leakage problem.

1. Complete confidence
2. Moderate confidence
3. Little confidence
4. No confidence

• How well do you control your urine leakage? (0 being “no control” to 10 being “full control”)

1. 0 (no control)
2. 1
3. 2
4. 3
5. 4
6. 5
7. 6
8. 7
9. 8
10. 9
11. 10 (full control)

Urination Frequency Items

• What is the frequency of your daytime urination?

1. 1–4 times per day
2. 5–8 times per day
3. 9–12 times per day
4. ≥13 times per day

• How often do you urinate at night?

1. Do not urinate at night
2. 1 time per night
3. 2 times per night
4. 3 times per night
5. 4 or more times per night

Urinary Retention Items

• How long can you delay urination from the first time you feel the urge?

1. 1 or more hours
2. 30 minutes
3. 15 minutes
4. less than 10 minutes
5. 1–2 minutes
6. Cannot delay urination

• After starting to urinate, can you:

1. Stop urine flow completely
2. Maintain a change to the urine stream
3. Partially deflect or change the urine stream
4. Unable to deflect, change, or slow urine stream

Evidence

Validity

A research was designed to evaluate psychometric properties and practicability of 21-UIQ, however the examiner removed 4 items (2, 11, 18, 19). The questionnaire still demonstrated a good construct and content validity in measuring urinary function in outpatients.

Reliability

The test was reliable and accurate in measuring urinary symptoms for majority of patients regardless the severity of their symptoms.