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Introduction: The Qualiveen questionnaire is a urinary disorder-specific health-related quality of life (HRQL) instrument. Developed in French, the instrument's translation into English was the first step of a process leading to an HRQL questionnaire that can be used in a different culture. However, the cultural adaptation of an HRQL questionnaire is achieved only when the psychometric properties of the translated questionnaire are documented., Aim: To develop an equivalent English version of the Qualiveen questionnaire and to assess its discriminative measurement properties., Methods: Fifty-five Canadian out-patients with multiple sclerosis (MS) completed a set of questionnaires, including the Qualiveen; the MS Quality Of Life-54 (MSQOL-54), an MS-specific HRQL questionnaire; urinary function assessment; and the expanded disability status scale (EDSS) twice at an interval of 2 to 4 weeks., Results: The English Qualiveen proved to be test-retest reliable (intraclass correlation coefficient=0.94). Consistent with a priori predictions, we found a strong association between overall Qualiveen score and degree of incontinence (0.63), a moderate association with type of urinary symptoms (0.49), a weak association with manner of voiding (0.28) and weak or absent associations with MSQOL-54, EDSS bladder/bowel and global EDSS domains. Predictions proved to be generally accurate (weighted kappa=0.65)., Conclusion: The test-retest reliability and cross-sectional construct validity of the English version of Qualiveen are excellent and similar to the original French version. Further studies should explore Qualiveen's longitudinal validity and responsiveness.

Objectives: To identify all available symptom and quality of life questionnaires for men and women with urinary disorders and assess their psychometric properties., Methods: We systematically reviewed the literature in Medline using the key words urinary disorders, urinary incontinence, bladder, score, quality of life, questionnaire, and psychometric validation., Results: The first search using the terms urinary incontinence and quality of life resulted in 1018 Abstracts. Articles mentioning but not measuring quality of life were not investigated. Questionnaires were selected because their psychometric properties were tested and they assessed how much a person was bothered by urinary symptoms or quality of life specific to urinary disorders. The questionnaires were usually gender specific. Their psychometric value was far from uniform, and, for most, responsiveness was not reported., Conclusion: Few quality of life questionnaires are at an advanced stage of validation to be applied in clinical practice. They need to be shorter, responsive and validated in different populations to permit their easy use.

Objectives: To assess the impact of urinary disorders on multiple sclerosis (MS) patients' health-related quality of life and to examine the cross-sectional construct validity of Qualiveen, a questionnaire originally developed for spinal cord injury patients with urinary disorders, in patients with MS., Design: Cohort study., Setting: Neurourodynamic units in 3 French university hospitals., Participants: Patients with MS (N=197)., Interventions: Not applicable., Main Outcome Measures: We tested predictions about the relationships among clinical features, the French version of the Multiple Sclerosis Quality of Life questionnaire (SEP-59), the Expanded Disability Status Scale (EDSS), and the 4 domains of the 30-item Qualiveen., Results: Cross-sectional correlations among the 4 Qualiveen domains and type (range, .36-.54), number of symptoms (range, .23-.50), and severity of incontinence (.39-.68) were generally moderate to strong. The SEP-59 bowel and bladder function domain showed moderate to strong relationships with the Qualiveen (range, .39-.59). Relationships with other SEP-59 domains were generally weak (range, .22-.35), and with the EDSS they were very weak. Predictions proved generally accurate (weighted kappa=.61)., Conclusions: Our data supported the Qualiveen's validity as a discriminative instrument for use with patients with MS. Further studies should explore the Qualiveen's longitudinal validity and responsiveness.

Objective: Botulinum toxin (BT) injection into the external urethral sphincter is a promising therapy for neurogenic voiding disorders due to detrusor-sphincter dyssynergia (DSD). However the optimal treatment protocol remains unclear., Method: A PubMed reference search and manual bibliography review were performed, along with a search in the Annales de réadaptation et de médecine physique and in the reports of the International French-language Society of Urodynamics and the International Continence Society, which allowed us to select twelve pertinent articles with PubMed, two articles from the Annales and two conference reports. Our analysis gave special emphasis to assessment criteria, application, dosage and BT injection technique., Results: Used for the first time in 1988 in spinal cord injury patients to reduce outflow obstruction due to DSD, BT injections have been shown to be a valuable alternative management of bladder dysfunction with DSD. They have been proposed in neurological patients unable to perform self-catheterisation, after drug failure and before surgery. Parameters for results assessment are mostly clinical (increased free interval between voiding, decreased post-void residual urine volumes), urodynamic (improvement in bladder emptying, increase in functional bladder capacity and decrease in urethral pressure) and electromyographic (denervation of striated urethral sphincter). The literature data regarding type of BT, dosage and protocol vary widely. Duration of action is from 2 to 12 months. Both transurethral and transperineal injections monitored by EMG are equally effective in improving detrusor-sphincter dyssynergia., Conclusion: With few side effects and satisfactory medium-term results, BT should be recommended as a component of DSD therapies. We propose a practical method for BT use.