Cross-Cultural Adaptation and Validation of Incontinence Outcome Questionnaire for Serbian Population

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Abstract
Background and Objectives: Stress urinary incontinence (SUI) impacts 4–50% of adult women, frequently resulting in embarrassment, diminished self-esteem, and social withdrawal, significantly affecting quality of life. The aim of our study is to cross-culturally adapt and validate the Urinary Incontinence Outcome Questionnaire (IOQ) for the Serbian population and to assess the multifaceted impact of SUI on the quality of life among women. Materials and Methods: A cross-sectional study involved a total of 150 women: 100 undergoing surgical management for SUI (ST group) and 50 receiving non-surgical treatments, including vaginal estrogen, pessaries, electrical stimulation, or collagen fillers (NST group). The participants completed questionnaires on demographics, fatigue (MFI), anxiety and depression (HADS), and quality of life (SF-36), as well as the IOQ. Results: The ST group had a mean age of 60.0 ± 10.0 years, with 65% married, 65% with secondary education, 62% non-smokers, and 78% with comorbid conditions, primarily cardiovascular disease (59%). The NST group showed similar characteristics, with a significant difference in cardiovascular comorbidity (p = 0.049). All IOQ subscales demonstrated good internal consistency (Cronbach alpha > 0.7), except for the subscale Complications (Cronbach alpha = 0.440). The IOQ score for “Symptoms pre-operative” had the highest mean value (62.8 ± 18.6), while “Hospital Re-admission” had the lowest (303 ± 17.1). A comparison of the SF-36 scores showed significant differences in the Energy (p = 0.025) and Emotional well-being (p = 0.015) domains between the ST and NST groups. Conclusions: The Serbian version of the IOQ has been validated, demonstrating psychometric features that endorse its application in clinical and research contexts. This study highlights the significant impact of SUI on quality of life and the need for a comprehensive approach to treatment. The results emphasize the importance of addressing both the physical and psychological aspects of SUI to improve the lives of affected women.

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