Assessment Tools & Questionnaires
Validated patient-reported outcome measures (PROMs), severity grading scales, and objective assessment tools are the foundation of reconstructive-urology and urogynecology workup. They anchor the clinical conversation, document baseline severity, guide surgical decision-making, and provide the objective endpoints for quality reporting and research.
This page catalogs the major validated instruments used in GU reconstructive practice, organized by clinical domain. For each tool, the entries cover purpose, scoring, validation, and clinical role — not the psychometric minutiae available in the primary literature.
Erectile and Sexual Function
SHIM / IIEF-5 (Sexual Health Inventory for Men)
The short-form 5-item version of the International Index of Erectile Function (IIEF), focused on erectile function over the past 6 months.[1][2]
| Parameter | Detail |
|---|---|
| Questions | 5 — confidence, firmness for penetration, maintenance during intercourse, difficulty maintaining to completion, satisfaction |
| Scoring range | 1–25 |
| ED severity | Severe 1–7, Moderate 8–11, Mild-moderate 12–16, Mild 17–21, No ED 22–25 |
| Time horizon | Past 6 months |
| Validation | >10 languages; the single most-cited male sexual function instrument (>4,500 citations)[2] |
| Clinical role | Baseline ED assessment; response to PDE5i / VED / ICI; pre- and post-implant comparison |
Limitation: SHIM captures ED severity specifically, not broader sexual function. For the latter, use EPIC-SF (Expanded Prostate Cancer Index Sexual Function) or PCI-SF in prostate-cancer populations.[3]
Full IIEF (IIEF-15)
Comprehensive 15-item instrument covering 5 domains: erectile function, orgasmic/ejaculatory function, sexual desire, intercourse satisfaction, and overall satisfaction.[2]
Used in:
- Clinical trials requiring multi-domain outcome capture
- Research studies where SHIM alone is insufficient
- Peyronie's disease work-up in combination with the PDQ (Peyronie's Disease Questionnaire) for psychosocial and sexual-function tracking
Female Sexual Function
For the clinical-conditions framework see Female Sexual Dysfunction. Female sexual dysfunction (FSD) remains a clinical diagnosis based on history, examination, and assessment of distress; the validated instruments below are recommended by ACOG and AAFP as adjuncts to the clinical interview, not as required diagnostic criteria.[28][29] Sexually-related personal distress is a required diagnostic criterion under DSM-5 and ICD-11, which is why a distress instrument (FSDS-R) is paired with a function instrument (FSFI) in most contemporary trials.
FSFI-19 (Female Sexual Function Index)
The most widely used and cited instrument in FSD research.[30]
| Parameter | Detail |
|---|---|
| Items | 19 (self-report) |
| Domains | Desire, arousal, lubrication, orgasm, satisfaction, pain (6 domains) |
| Recall | 4 weeks |
| Scoring | Domain scores weighted and summed; total range 2–36; total ≤ 26.55 is the conventional FSD cutoff (a stricter ≤ 23.1 cutoff has been proposed using DSM-5-TR criteria) |
| Psychometrics (COSMIN SR, 83 studies) | Sufficient internal consistency, sufficient reliability, sufficient criterion validity. Structural-validity evidence inconsistent; data on measurement error, responsiveness, cross-cultural validity were lacking.[30] |
| Languages | Validated in English, Spanish, Arabic, Chinese, and at least 5 others |
| Limitations | 19-item length cumbersome in routine practice; does not capture sexual inactivity or vulvar discomfort |
| Trial use | The FSFI-desire domain was a coprimary endpoint in the pivotal trials for both flibanserin and bremelanotide.[31] |
FSFI-6 and FSFI-9 (short forms)
- FSFI-6 — 6-item abbreviation (one item per domain, excluding pain). Sufficient criterion validity (moderate quality); inconsistent reliability and construct-validity evidence. Best for studies where sexual function is a secondary endpoint and brevity matters.[30]
- FSFI-9 — 9-item psychometrically sound short version validated in peri- and postmenopausal women.
FSDS / FSDS-R / FSDS-DAO (Female Sexual Distress Scale)
- FSDS — original 12-item self-report measure of sexually related personal distress; 0–4 per item; 30-day recall; total ≥ 11 is the commonly used cutoff for clinically significant distress; ICC > 0.74; Cronbach's α > 0.86.[32]
- FSDS-R (Revised) — 13-item version that adds Item 13 ("How often did you feel bothered by low sexual desire?") to enhance HSDD sensitivity. The FSDS-R total and Item 13 are the most commonly used distress endpoints in HSDD clinical trials, including the pivotal trials for flibanserin and bremelanotide. 30-day and 7-day recall periods produce equivalent results.[31][32]
- FSDS-DAO (Desire, Arousal, Orgasm) — further revision adding distress items specific to arousal and orgasm. Item 13 of the FSDS-DAO was a coprimary endpoint in the bremelanotide RECONNECT trials.[31]
DSDS (Decreased Sexual Desire Screener)
A brief, 5-item diagnostic instrument specifically designed for non-specialist clinicians to diagnose generalized acquired HSDD.[33]
| Parameter | Detail |
|---|---|
| Items | 4 patient yes/no items + 1 collaborative clinician item to rule out other causes |
| Time | ~ 2 minutes — the most efficient validated diagnostic tool for HSDD |
| Sensitivity / specificity | 83.6–96.0% / 87.8% |
| Diagnostic agreement with expert clinician interview | 85.2%; non-expert clinicians considered the DSDS adequate to diagnose HSDD in 92.9% of cases |
| Endorsement | Recommended by ISSWSH as a clinical diagnostic tool for HSDD |
SIDI-F (Sexual Interest and Desire Inventory–Female)
A 13-item clinician-administered scale specifically designed to measure HSDD severity (not general FSD).[34]
- Cronbach's α 0.90; high test-retest reliability; strong convergent validity with the FSFI; differentiates HSDD from other FSD subtypes and from women without FSD.
- SIDI-F-SR self-report version showed high agreement with the clinician version (ICC 0.86); women scored ~ 1 point higher on the self-report version.
- Particularly useful for quantifying HSDD severity and monitoring treatment response.
PROMIS Sexual Function and Satisfaction (SexFS) v2.0
NIH-developed customizable, modular instrument with 11 scored scales — interest in sexual activity, lubrication, vaginal discomfort, clitoral discomfort, labial discomfort, orgasm ability, orgasm pleasure, oral dryness, oral discomfort, satisfaction.[35]
- Scores centered on norms for sexually active US adults; applicable to both men and women, with or without a partner.
- Unique scales for vulvar discomfort (labial and clitoral) not found in other instruments — ~ 1 in 5 US women endorse some degree of vulvar discomfort with sexual activity.
- ACOG recommends a validated single-item screener developed using the PROMIS framework for use during patient intake to facilitate clinical discussion.[28]
PISQ-IR (Pelvic Organ Prolapse / Incontinence Sexual Questionnaire — IUGA Revised)
A condition-specific validated questionnaire for women with pelvic-floor disorders — sexually active women answer 21 questions in 6 domains; sexually inactive women answer 12 questions in 4 domains. Uniquely captures sexual inactivity due to pelvic-floor disorders or other causes — useful in incontinence / prolapse outcome work where the FSFI's exclusion of inactive patients is a limitation.[36]
Comparison Table
| Instrument | Items | Administration | Primary use | Key domains |
|---|---|---|---|---|
| FSFI-19 | 19 | Self-report | Comprehensive FSD assessment | Desire, arousal, lubrication, orgasm, satisfaction, pain |
| FSFI-6 | 6 | Self-report | Brief FSD screening | One item per domain (excl. pain) |
| FSFI-9 | 9 | Self-report | Brief FSD assessment (peri / postmenopausal) | Abbreviated domains |
| FSDS | 12 | Self-report | Sexual-distress measurement | Global sexually-related distress |
| FSDS-R | 13 | Self-report | Distress (HSDD-sensitive) | Global distress + low-desire distress (Item 13) |
| FSDS-DAO | 15 | Self-report | Distress (desire / arousal / orgasm) | Distress specific to desire, arousal, orgasm |
| DSDS | 5 | Patient + clinician | HSDD diagnosis by non-specialists | Generalized acquired HSDD screening / diagnosis |
| SIDI-F | 13 | Clinician | HSDD severity measurement | Desire symptoms, comorbid factors |
| SIDI-F-SR | 13 | Self-report | HSDD severity (self-report alternative) | Same as SIDI-F |
| PROMIS SexFS v2.0 | Modular (11 scales) | Self-report | Customizable function assessment | Interest, lubrication, vulvar discomfort, orgasm, satisfaction |
| PISQ-IR | 21 active / 12 inactive | Self-report | Sexual function in pelvic-floor disorders | Condition-specific; captures sexual inactivity |
Practical guidance — which instrument to use when
- Busy primary-care or non-specialist clinic, suspected HSDD → DSDS (5 items, ~ 2 min) is the most efficient validated diagnostic tool.[33]
- Routine FSD screening / intake → ACOG-recommended PROMIS single-item screener or FSFI-6.[28]
- Comprehensive baseline + treatment-response tracking → FSFI-19 paired with FSDS-R is the contemporary standard pairing of function + distress.[30][32]
- Quantifying HSDD severity / monitoring treatment response → SIDI-F-SR.[34]
- Pelvic-floor-disorder cohort (POP / SUI / OAB) including sexually inactive women → PISQ-IR (the FSFI excludes inactive patients).[36]
- Patient with prominent vulvar / labial / clitoral discomfort → PROMIS SexFS v2.0 (the only instrument with dedicated vulvar-discomfort scales).[35]
- HSDD clinical-trial endpoints → FSFI-desire domain + FSDS-R Item 13 are the FDA-endorsed coprimary endpoints (the pivotal trials for flibanserin and bremelanotide used these).[31]
Guideline positions
- ACOG 2019 (PB 213)[28] — initiate clinical discussion at routine visits; brief PROMIS single-item screener at intake; FSFI and FSDS as useful adjuncts.
- AAFP 2025 (Dalrymple)[29] — open-ended screening at routine visits; FSFI and FSDS-R highlighted as validated tools. Questionnaires are not required for diagnosis or treatment.
- ISSWSH 2018 / 2020[33] — DSDS and / or sexual history as the recommended HSDD diagnostic tool in clinical practice.
- FDA — endorses FSFI-desire domain and FSDS-R Item 13 as appropriate coprimary endpoints for HSDD clinical trials.[31]
Pelvic Organ Prolapse
POP-Q (Pelvic Organ Prolapse Quantification)
The only validated objective method for measuring prolapse. Recommended before treatment by ACOG, AUGS, SGS, and ICS.[4][5]
Six vaginal reference points, all measured relative to the hymen (0 cm) — positive values are beyond the hymen, negative values are above it:
| Point | Location |
|---|---|
| Aa | Anterior vaginal wall, 3 cm proximal to urethral meatus |
| Ba | Most dependent point of the anterior vaginal wall |
| Ap | Posterior vaginal wall, 3 cm proximal to hymen |
| Bp | Most dependent point of the posterior vaginal wall |
| C | Most distal edge of the cervix or vaginal cuff |
| D | Posterior fornix (when cervix is present) |
Plus three linear measurements:
- GH — genital hiatus (external urethral meatus to posterior midline hymen)
- PB — perineal body (posterior hymen to mid-anal opening)
- TVL — total vaginal length
Staging (based on most severely prolapsed segment):
| Stage | Definition |
|---|---|
| 0 | No prolapse; all points ≤ –3 cm (Aa, Ap) and C ≤ –(TVL − 2) |
| I | Most distal portion > 1 cm above the hymen |
| II | Most distal portion within 1 cm of the hymen (above or below) |
| III | Most distal portion > 1 cm below the hymen but < TVL − 2 |
| IV | Complete eversion |
Simplified POP-Q (S-POP) — adequate reproducibility for busy clinical practice; uses fewer measurements.[6]
PFDI-20 and PFIQ-7 (Pelvic Floor Distress / Impact)
- PFDI-20 (Pelvic Floor Distress Inventory-20): 20 items, range 0–300, distress from pelvic floor symptoms across three subscales (UDI-6 urinary, POPDI-6 prolapse, CRAD-8 colorectal-anal)[7]
- PFIQ-7 (Pelvic Floor Impact Questionnaire-7): 21 items total (7 per subscale), range 0–300, quality of life impact across the same three domains
Paired use captures both symptom distress and functional impact.
PISQ-IR (Pelvic Organ Prolapse / Incontinence Sexual Questionnaire — IUGA-Revised)
Validated sexual function assessment specifically for women with prolapse and/or incontinence. Captures the sexual-function domain that PFDI-20 / PFIQ-7 do not.[20]
Urinary Incontinence — Objective Severity
Pad Weight Tests
Standardized objective measurement of urinary leakage. Differ by duration.[8][9][10]
| Test | Duration | Best use | Accuracy |
|---|---|---|---|
| 1-hour pad test | ICS-standardized protocol with fixed provocative maneuvers | Initial diagnosis | Sensitivity 60–93%, specificity 60–84%; less reproducible than longer tests[8] |
| 24-hour pad test | 24 hours of normal daily activity | Treatment-outcome gold standard | More clinically useful than 1-hour[8][11] |
| 7-day pad test | One week of normal activity | Captures maximum leakage; strong correlation with 24-hour and moderate correlation with ICIQ-SF | Best capture of peak leakage[10] |
Interpretation: Abnormal increase defined as >15 g pad weight gain.[12]
Clinical role: Underutilized despite being inexpensive, easy to perform, and valuable for diagnosis, treatment selection, and outcome assessment.[9]
MSIGS (Male Stress Incontinence Grading Scale)
Grading system using the Standing Cough Test for male stress urinary incontinence.[13]
| Grade | Observed leakage |
|---|---|
| 0 | No leakage |
| 1 | Drops / trickle |
| 2 | Stream — ends before coughing ends |
| 3 | Stream — persists through cough |
| 4 | Leakage with minimal provocation / Valsalva |
Clinical utility: Adds prognostic value to pads-per-day in predicting transobturator sling success; incorporated into the Shakir refined nomogram for sling candidate selection. Increasing MSIGS grade associated with treatment failure.[13]
Voiding / Bladder Diaries
3–7 day diary of fluid intake, voiding events, and incontinence episodes. Captures storage LUTS, identifies modifiable factors (fluid volume, caffeine, diuretic timing), and monitors response to treatment.[14][15]
ICIQ Bladder Diary (validated)
The 3-day ICIQ bladder diary is the validated standard.[16] Records:
- Time and volume of each void
- Fluid intake (type and volume)
- Incontinence episodes with circumstances (urge, stress, leakage with activity)
- Pad use
AUA/SUFU OAB guideline recommendation: bladder diary is part of the standard OAB workup — for diagnosis, excluding alternative conditions, assessing bother, and evaluating treatment response.[15]
Role alongside urodynamics: complementary — more accessible, affordable, and can be completed at home. Particularly valuable in resource-limited settings or when urodynamic equipment is unavailable.[14]
Lower Urinary Tract Symptoms
| Instrument | Population | Key features |
|---|---|---|
| IPSS (International Prostate Symptom Score) | Men (and by extension mixed LUTS) | 7 symptom items + 1 QoL item; gold-standard BPH/LUTS assessment[17][18] |
| ICIQ-UI-SF (Short Form) | All adults | 4 items; frequency, volume, bother, circumstance; heavily validated and cited[2] |
| ICIQ-LUTS-QOL | All adults | Quality-of-life impact of LUTS[17] |
| ICSmaleSF | Men | Male-specific LUTS short form[18] |
| LURN-SI-29 / LURN-SI-10 | All genders | Voiding, storage, and incontinence symptoms; validated across genders[15] |
| Bristol Female LUTS | Women | Comprehensive female-specific LUTS[15] |
Incontinence-Specific
| Instrument | Purpose |
|---|---|
| ISI (Incontinence Symptom Index) | Severity + bother across incontinence types[19] |
| IIQ-7 (Incontinence Impact Questionnaire-7) | Emotional and functional impact of incontinence[19] |
| UDI-6 (Urogenital Distress Inventory-6) | Short form urogenital distress (overlaps PFDI-20)[2][17] |
Urethral Stricture Disease
USS-PROM (Urethral Stricture Surgery PROM)
The disease-specific PROM for anterior urethral reconstruction. Validated by the BAUS section; combines LUTS, health-status (EQ-5D), and treatment satisfaction items.[21][22]
Clinical role: baseline documentation and longitudinal tracking before and after urethroplasty. The USS-PROM has largely replaced ad-hoc symptom scoring in urethral-reconstruction research and high-volume clinics.
Urethral Stricture Score
Validated scoring system predictive of operative complexity, recurrence, and complications.[23][24] Incorporates:
- Stricture Length
- Segment (anatomic location)
- Etiology
An extension — the LSE system — provides further stratification. Both are predictive of operative decision-making (graft vs. excision-primary anastomosis), complication risk, and recurrence.
Other Validated Tools
| Instrument | Domain |
|---|---|
| EPIC (Expanded Prostate Cancer Index Composite) | Post-prostate-cancer urinary, sexual, and bowel function — widely used in prostate-cancer reconstruction research[18] |
| NIH-CPSI (NIH Chronic Prostatitis Symptom Index) | Pain, urination, and overall impact in chronic prostatitis / CPPS[25] |
| ICIQ-S (ICIQ-Satisfaction) | Validated satisfaction measure after urological surgery — useful for postoperative outcome reporting across reconstructive procedures[26] |
| EQ-5D | Generic health-related quality of life; component of USS-PROM and many other disease-specific bundles[21][22][27] |
| PDQ (Peyronie's Disease Questionnaire) | Peyronie's-specific psychosocial, sexual function, and pain domains |
How to Use These in Practice
At initial visit
- Men with ED → SHIM / IIEF-5 (baseline) + PDQ if curvature / plaque
- Men with LUTS → IPSS + ICIQ-UI-SF (if incontinence) + bladder diary
- Men with SUI (post-prostatectomy) → pads-per-day + MSIGS / standing cough test + 24-hour pad test
- Women with prolapse → POP-Q exam + PFDI-20 + PFIQ-7 + PISQ-IR if sexually active
- Women with incontinence → ICIQ-UI-SF + UDI-6 + IIQ-7 + bladder diary + pad test
- Men / women with urethral stricture → USS-PROM + stricture scoring (LSE / USS)
At follow-up
- Re-administer the same instruments used at baseline — comparability is the value
- Pad tests preferred for objective verification of incontinence-surgery outcomes (24-hour or 7-day)
- ICIQ-S for generic post-surgical satisfaction benchmarking
Counseling role
Validated instruments provide the reference anchor for the subjective-vs-objective disconnect that patients consistently report after reconstructive surgery — men who report "much worse shortening" than objective measurement shows, women who report persistent "leakage" that doesn't register on pad testing. Use the numbers to ground the conversation.
See Also
- Female Pelvic Examination & POP-Q — including POP-Q technique
- Male Urogenital Exam
- Urodynamics
- Erectile Dysfunction — clinical use of SHIM / IIEF
- Peyronie's Disease — PDQ + IIEF in workup
References
1. Cappelleri JC, Rosen RC. The Sexual Health Inventory for Men (SHIM): a 5-year review of research and clinical experience. Int J Impot Res. 2005;17(4):307–19. doi:10.1038/sj.ijir.3901327
2. Bordeianou LG, Anger JT, Boutros M, et al. Measuring pelvic floor disorder symptoms using patient-reported instruments: proceedings of the consensus meeting of the Pelvic Floor Consortium of ASCRS, ICS, AUGS, and SUFU. Female Pelvic Med Reconstr Surg. 2020;26(1):1–15. doi:10.1097/SPV.0000000000000817
3. Levinson AW, Ward NT, Sanda MG, et al. Comparison of validated instruments measuring sexual function in men. Urology. 2010;76(2):380–386. doi:10.1016/j.urology.2010.04.033
4. American College of Obstetricians and Gynecologists. Pelvic organ prolapse: ACOG practice bulletin, number 214. Obstet Gynecol. 2019;134(5):e126–e142. doi:10.1097/AOG.0000000000003519
5. AUGS / SGS. Pelvic organ prolapse. Female Pelvic Med Reconstr Surg. 2019;25(6):397–408. doi:10.1097/SPV.0000000000000794
6. Madhu C, Swift S, Moloney-Geany S, Drake MJ. How to use the Pelvic Organ Prolapse Quantification (POP-Q) system? Neurourol Urodyn. 2018;37(S6):S39–S43. doi:10.1002/nau.23740
7. Haya N, Feiner B, Baessler K, Christmann-Schmid C, Maher C. Perioperative interventions in pelvic organ prolapse surgery. Cochrane Database Syst Rev. 2018;8:CD013105. doi:10.1002/14651858.CD013105
8. Medeiros Araujo C, de Morais NR, Sacomori C, de Sousa Dantas D. Pad test for urinary incontinence diagnosis in adults: systematic review of diagnostic test accuracy. Neurourol Urodyn. 2022;41(3):696–709. doi:10.1002/nau.24878
9. Krhut J, Zachoval R, Smith PP, et al. Pad weight testing in the evaluation of urinary incontinence. Neurourol Urodyn. 2014;33(5):507–10. doi:10.1002/nau.22436
10. Martínez-Cuenca E, Sánchez JV, Bonillo MÁ, et al. Longer is better than shorter: the added value of the seven-day pad test in the post-radical prostatectomy urinary incontinence. Neurourol Urodyn. 2021;40(4):994–1000. doi:10.1002/nau.24655
11. Matharu GS, Assassa RP, Williams KS, et al. Objective assessment of urinary incontinence in women: comparison of the one-hour and 24-hour pad tests. Eur Urol. 2004;45(2):208–12. doi:10.1016/j.eururo.2003.09.006
12. Holroyd-Leduc JM, Tannenbaum C, Thorpe KE, Straus SE. What type of urinary incontinence does this woman have? JAMA. 2008;299(12):1446–56. doi:10.1001/jama.299.12.1446
13. Shakir NA, Fuchs JS, McKibben MJ, et al. Refined nomogram incorporating standing cough test improves prediction of male transobturator sling success. Neurourol Urodyn. 2018;37(8):2632–2637. doi:10.1002/nau.23703
14. Liapis I, Gammie A, Mohamed-Ahmed R, et al. Can we increase the value of data from bladder diaries? International Consultation on Incontinence-Research Society 2023. Neurourol Urodyn. 2024;43(6):1311–1320. doi:10.1002/nau.25374
15. Cameron AP, Chung DE, Dielubanza EJ, et al. The AUA/SUFU guideline on the diagnosis and treatment of idiopathic overactive bladder. J Urol. 2024;212(1):11–20. doi:10.1097/JU.0000000000003985
16. Bright E, Cotterill N, Drake M, Abrams P. Developing and validating the International Consultation on Incontinence Questionnaire Bladder Diary. Eur Urol. 2014;66(2):294–300. doi:10.1016/j.eururo.2014.02.057
17. D'hulst P, Muilwijk T, Vander Eeckt K, Van der Aa F, Joniau S. Patient-reported outcomes after buccal mucosal graft urethroplasty for bulbar urethral strictures. BJU Int. 2020;126(6):684–693. doi:10.1111/bju.15131
18. Donovan JL, Hamdy FC, Lane JA, et al. Patient-reported outcomes after monitoring, surgery, or radiotherapy for prostate cancer. N Engl J Med. 2016;375(15):1425–1437. doi:10.1056/NEJMoa1606221
19. Wingate JT, Erickson BA, Murphy G, et al. Multicenter analysis of patient reported outcomes following artificial urinary sphincter placement for male stress urinary incontinence. J Urol. 2018;199(3):785–790. doi:10.1016/j.juro.2017.09.089
20. Gray TG, Vickers H, Krishnaswamy P, Jha S. A systematic review of English language patient-reported outcome measures for use in urogynaecology and female pelvic medicine. Int Urogynecol J. 2021;32(8):2033–2092. doi:10.1007/s00192-021-04810-1
21. Jackson MJ, Chaudhury I, Mangera A, et al. A prospective patient-centred evaluation of urethroplasty for anterior urethral stricture using a validated patient-reported outcome measure. Eur Urol. 2013;64(5):777–82. doi:10.1016/j.eururo.2013.04.037
22. Horiguchi A, Shinchi M, Ojima K, et al. Evaluation of the effect of urethroplasty for anterior urethral strictures by a validated disease-specific patient-reported outcome measure. World J Urol. 2019;37(4):601–606. doi:10.1007/s00345-018-2540-z
23. Kurtzman JT, Kosber R, Kerr P, Brandes SB. Evaluating tools for characterizing anterior urethral stricture disease: a comparison of the LSE system and the Urethral Stricture Score. J Urol. 2022;208(5):1083–1089. doi:10.1097/JU.0000000000002880
24. John A, Kahokehr AA. Classification systems for anterior urethral stricture disease in men: a systematic review. World J Urol. 2021;39(3):761–769. doi:10.1007/s00345-020-03250-8
25. Schaeffer AJ. Chronic prostatitis and the chronic pelvic pain syndrome. N Engl J Med. 2006;355(16):1690–8. doi:10.1056/NEJMcp060423
26. Uren AD, Cotterill N, Hashim H, et al. International Consultation on Incontinence Questionnaire-Satisfaction: psychometric testing of a new patient-reported outcome measure for the evaluation of satisfaction after urological surgery. BJU Int. 2020;126(2):286–291. doi:10.1111/bju.15091
27. Chung PH, Vanni AJ, Breyer BN, et al. Evaluation of generic versus condition-specific quality of life indicators for successful urethral stricture surgery. Urology. 2019;126:222–226. doi:10.1016/j.urology.2018.12.009
28. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Gynecology. Female sexual dysfunction: ACOG Practice Bulletin Number 213. Obstet Gynecol. 2019;134(1):e1–e18. doi:10.1097/AOG.0000000000003324
29. Dalrymple SN, Hoeg L, Thacker H. Female sexual dysfunction: common questions and answers. Am Fam Physician. 2025;111(5):433–442.
30. Neijenhuijs KI, Hooghiemstra N, Holtmaat K, et al. The Female Sexual Function Index (FSFI) — a systematic review of measurement properties. J Sex Med. 2019;16(5):640–660. doi:10.1016/j.jsxm.2019.03.001
31. Derogatis LR, Revicki DA, Clayton AH. Instruments for screening, diagnosis, and management of patients with generalized acquired hypoactive sexual desire disorder. J Womens Health. 2020;29(6):806–814. doi:10.1089/jwh.2019.7917
32. Derogatis L, Clayton A, Lewis-D'Agostino D, Wunderlich G, Fu Y. Validation of the Female Sexual Distress Scale-Revised for assessing distress in women with hypoactive sexual desire disorder. J Sex Med. 2008;5(2):357–364. doi:10.1111/j.1743-6109.2007.00672.x
33. Clayton AH, Goldfischer ER, Goldstein I, et al. Validation of the Decreased Sexual Desire Screener (DSDS): a brief diagnostic instrument for generalized acquired female hypoactive sexual desire disorder (HSDD). J Sex Med. 2009;6(3):730–738. doi:10.1111/j.1743-6109.2008.01153.x
34. Clayton AH, Segraves RT, Leiblum S, et al. Reliability and validity of the Sexual Interest and Desire Inventory–Female (SIDI-F), a scale designed to measure severity of female hypoactive sexual desire disorder. J Sex Marital Ther. 2006;32(2):115–135. doi:10.1080/00926230500442300
35. Weinfurt KP, Lin L, Bruner DW, et al. Development and initial validation of the PROMIS Sexual Function and Satisfaction measures version 2.0. J Sex Med. 2015;12(9):1961–1974. doi:10.1111/jsm.12966
36. Bordeianou LG, Anger JT, Boutros M, et al. Measuring pelvic floor disorder symptoms using patient-reported instruments: proceedings of the consensus meeting of the Pelvic Floor Consortium of ASCRS, ICS, AUGS, and SUFU. Female Pelvic Med Reconstr Surg. 2020;26(1):1–15. doi:10.1097/SPV.0000000000000817