Australian Pelvic Floor Questionnaire

Please mark x in the box that best describes your symptoms in the last month.

Australian pelvic floor questionnaire. Once completed you can compare your scores to that of healthy volunteers and those referred for treatment. The self administered australian pelvic floor questionnaire apfq comprehensively integrates four domains to assess bladder bowel prolapse and sexual symptoms their severity their bother and impact on quality of life. Bladder section q 1 14 score 42 urinary frequency how many times do you pass urine in the day. It has recently been validated in pregnant and postpartum women and designed to facilitate clinical assessment of pelvic.

It also advises women to ensure their exercise program is pelvic floor friendly. This short screening tool is designed for women to check if at risk of pelvic floor problems. The australian pelvic floor questionaire please circle your most applicable answer. Do you experience urine leakage incontinence related to physical activity such as.

Erience during the last month. Consider your exp patient s name. How many times to you get up at night to pass urine. Page 1 of 2 australian pelvic floor questionnaire please circle your most applicable answer.

All information is strictly confidential. Takes 5 minutes to complete. 0 0 1 1 2 2 3. The australian pelvic floor questionnaire apfq is a validated multi lingual self completed questionnaire that evaluates and scores all four areas of female pelvic floor dysfunction.

Queensland female pelvic floor questionnaire 1 patient. For example the australian pelvic floor questionnaire as used by behnia et al 15 was tested and validated in a population of women with varying pelvic floor disorders. How many times do you pass urine in the day. The australian pelvic floor questionnaire bladder and bowel domain scores demonstrated moderate positive correlations with the international consultation on incontinence questionnaire short form questionnaire for urinary incontinence r 0 74 p 0 01 and the international consultation on incontinence questionnaire bowel module r 0 69.

Consider your experiences during the last month. 0 up to 7 1 between 8 10 2 between 11 15 3 more than 15 nocturia how many times do you get up at night to pass urine. Pelvic floor bother questionnaire. The australian pelvic floor questionnaire apfq is a validated multi lingual self completed questionnaire that evaluates and scores all four areas of female pelvic floor dysfunction.