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Oncology Section EDGE Task Force on Urogenital Cancer

A Systematic Review of Clinical Measures for Incontinence

Jeffrey, Alicia, PT, DPT1; Harrington, Shana E., PT, PhD, SCS, MTC2; Hill, Alexandra, PT, DPT, WCS, CLT3; Roscow, Amanda, PT, DPT4; Alappattu, Meryl, PT, DPT, PhD5

doi: 10.1097/01.REO.0000000000000068

Background: Compared with the general population, women and men with urogenital and colorectal cancers experience higher rates of urinary and fecal incontinence. Although a variety of measures exist to assess these areas, currently, there are no guidelines recommending which outcomes rehabilitation professionals should administer to examine these impairments in those with cancer.

Purpose: To identify outcome measures for assessing urinary and fecal incontinence and evaluate their psychometric data and applicability to the cancer population.

Methods: Multiple electronic databases (CINAHL, MEDLINE, PsycINFO) were reviewed using specific search terms to locate articles that identify outcome measures assessing urinary and fecal incontinence. As part of a larger effort to identify outcome measures for both incontinence and sexual dysfunction, 1118 articles were initially identified, 228 articles were reviewed, and 37 outcome measures were selected for analysis, 13 of which were related to urinary and fecal incontinence. Each incontinence outcome measure was independently reviewed and rated by 2 reviewers using the Cancer Evaluation Database to Guide Effectiveness (EDGE) Task Force Outcome Measure Rating Form. Any discrepancies between reviewers were discussed, and an overall recommendation for each outcome measure was made using the 4-point Cancer EDGE Task Force Rating Scale.

Results: The Task Force was able to highly recommend 1 measure addressing urinary incontinence (American Urological Association Symptom Index) and 2 measures assessing urinary and fecal incontinence (Pelvic Floor Distress Inventory–Short Form, and Pelvic Floor Impact Questionnaire–Short Form). The Task Force also recommended 2 measures of urinary incontinence that demonstrated strong psychometric properties but had not yet been evaluated in the cancer population (Incontinence Quality-of-Life Questionnaire, International Consultation on Incontinence Questionnaire–Short Form). The Task Force was unable to recommend any measures that solely addressed fecal incontinence.

Conclusions: Five of the 13 outcome measures assessing urinary incontinence and 2 of the 13 measures assessing urinary and fecal incontinence demonstrated satisfactory psychometric properties and application to the urogenital cancer population and are thereby recommended for use by the Task Force.

1Select Physical Therapy, Pensacola, FL

2Physical Therapy Program, University of South Carolina, Columbia, SC

3Department of Physical Therapy and Occupational Therapy, Duke University Health System, Durham, NC

4Health Sciences Department, Santa Fe College, Gainesville, FL

5Department of Physical Therapy, University of Florida, Gainesville, FL

Correspondence: Alicia Jeffrey, PT, DPT, Select Physical Therapy, 7581 US-98, Pensacola, FL 32506 (

The authors declare no conflicts of interest.

©2017 (C) Academy of Oncologic Physical Therapy, APTA
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