Urodynamic studies (UDS) are widely used to evaluate lower urinary tract symptoms, yet patient-reported experience remains difficult to quantify. The International Consultation on Incontinence Questionnaire–Urodynamics Satisfaction (ICIQ-UDS-S) was developed to assess patient satisfaction and perceived value of UDS (1). The original ICIQ-UDS-S, developed in English through a Delphi process, comprises 16 items, including 11 satisfaction items (Q1–11) and 5 value items (Q12–16), along with two free-text fields, and includes additional items assessing procedure-related discomfort (Q8a, Q9a) and associated bother (Q8b, Q9b) during and after the test. We aimed to perform a cross-cultural adaptation of the ICIQ-UDS-S into Turkish and to conduct a pilot evaluation of its measurement properties.

After Institutional Board Approval, the Turkish version of the questionnaire was developed using a standardized forward–backward translation protocol in accordance with international cross-cultural adaptation guidelines. Two independent bilingual translators performed forward translations, which were synthesized by an expert panel. A blinded back-translation was subsequently conducted and compared with the original instrument. Discrepancies were resolved through consensus meetings involving clinicians experienced in urodynamics and methodological experts.
Content validity was assessed by 10 domain experts who rated each item’s relevance on a 0–4 scale.
Following adaptation, the finalized Turkish version was prospectively administered to 115 native Turkish-speaking patients immediately after undergoing ICS-standard invasive UDS. Statistical analyses included assessment of data completeness, response distributions, and internal consistency (Cronbach’s alpha), as well as evaluation of the feasibility of construct validity testing.

The Turkish ICIQ-UDS-S demonstrated good face and content validity, with all items rated as relevant by expert reviewers. Data completeness was high, with 110 of 115 participants (95.6%) completing the questionnaire in full, and administration was feasible in the clinical setting.
The median age was 59 years (IQR: 44–72; range: 19–84), and the cohort consisted of 66 women (60.0%) and 44 men (40.0%).
A high proportion of patients selected the most favorable response category across most items, particularly for core satisfaction items. In contrast, items assessing discomfort and bother demonstrated relatively greater variability (Figure 1).
Internal consistency was acceptable for the overall scale (Cronbach’s α = 0.75), with domain-specific estimates of α = 0.70 for the satisfaction items and α = 0.80 for the value items.
The observed response distribution did not meet the statistical assumptions required for factor analysis; therefore, factor analysis was not performed.

The linguistic adaptation process was successful, and the instrument demonstrated acceptable internal consistency and feasibility in a clinical setting.
The high proportion of favorable responses across core satisfaction items suggests marked ceiling effects, which may reflect genuinely positive experiences but could also indicate limited response sensitivity or response bias, whereas items assessing discomfort and bother retained greater variability. These findings are broadly in line with the original development study, which also reported limited response variability and challenges in psychometric evaluation. The use of heterogeneous response formats across items may have contributed to the observed response patterns and limited the applicability of conventional psychometric approaches (2).

The Turkish version of the ICIQ-UDS-S was successfully cross-culturally adapted with good content validity and acceptable internal consistency and feasibility. Substantial ceiling effects and limited response variability restricted further psychometric evaluation. These findings support its use as a descriptive survey of patient experience following UDS. Further evaluation in larger and more diverse populations is warranted to better understand its suitability as a measurement scale.

Gardener N, Hashim H, Avery K, Abrams P. Development and psychometric evaluation of the ICIQ urodynamics satisfaction model: the ICIQ-UDS-S. Int. Contin. Soc.
Jones K, Uren A, Kuppanda P et al.  Development and pilot testing of the ICIQ-S-UDS – A questionnaire for assessing and auditing the patient satisfaction and value of urodynamics. Continence, Volume 17, 2026, 102313, doi: 10.1016/j.cont.2026.102313.