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Updated: Dec 27, 2025

Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse POP Quantification System
Published on: September 20, 2018
Development and initial psychometric testing of a body-image domain within an electronic pelvic floor questionnaire
Kaia Scurr1, Thomas G Gray2, Georgina L Jones3
1Academic Unit of Reproductive & Developmental Medicine, University of Sheffield, Sheffield, UK.
Introduction:
Urogynaecological conditions have been shown to negatively impact on body image in a number of previous studies. ePAQ-Pelvic Floor (ePAQ-PF) is a patient-reported outcome measure used in clinical practice to assess urogynaecological conditions and their impact on quality of life. This study aimed to develop and undertake initial psychometric testing of a new domain to assess urogynaecological body image within ePAQ-PF.
Methods:
A patient involvement group, analysis of free-text data from ePAQ-PF and a systematic review of existing PROMs assessing urogynaecological body image informed the content of a new body-image domain within ePAQ-PF. This was administered to 208 patients who consented to the use of their anonymised ePAQ-PF responses for research purposes. These data underwent factor analysis, internal consistency reliability and item-total correlation testing. Evidence-based hypotheses were formulated to test construct validity. Criterion validity was assessed against the Body-image Scale (BIS). Patients completed a separate questionnaire (QQ-11) to measure the face validity of ePAQ-PF.
Results:
Factor analysis revealed a four-item body-image domain with good internal consistency reliability (Cronbach's α = 0.899) and item-total correlation (Spearman's rank r > 0.40). ePAQ-PF body-image domain scores correlated significantly with the BIS scores (r = 0.501). Age, prolapse, sexual dysfunction, pelvic pain and urinary incontinence scores correlated significantly with body-image domain score. QQ-11 value scores demonstrated good acceptability.
Conclusions:
Body-image assessment should form part of routine care in urogynaecology. Preliminary results support the validity, reliability and functionality of the body-image domain in ePAQ-PF. Further psychometric testing of this is required, including tests of responsiveness and stability.
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