PFDI-20: Pelvic Floor Distress Inventory - 20
The PFDI-20 reports three pelvic floor symptom-bother domains from 0 to 100 and a 0-to-300 total. Survey Doctor uses a modified digital form.
Overview
The PFDI-20 asks 20 questions about pelvic floor symptoms and bother. The source form uses a three-month recall period and three domains scored 0-100; their sum runs 0-300. Survey Doctor's current one-step, all-required digital form differs from that source administration. Results describe reported distress and do not diagnose a condition.
Form details change comparability.
What the PFDI-20 measures
Barber, Walters, and Bump developed the PFDI-20 as a short form of the PFDI-46 for women with pelvic floor disorders. Its domains separate pelvic organ prolapse, colorectal-anal, and urinary distress. One area can account for most of the total.
The reviewed measure record describes symptoms during the last three months. The source form asks whether each symptom is present, then rates how much it bothers the person. Presence and bother serve different purposes.
Keep both steps visible.
Who should take this assessment?
- Women experiencing any combination of pelvic floor symptoms
- Adult women being evaluated for urinary incontinence, pelvic organ prolapse, or fecal incontinence
- People whose provider wants a structured record of symptom bother over time
Score interpretation
Each domain runs from 0 to 100. The three domain scores add to a total from 0 to 300. Higher numbers reflect more reported bother on this scale.
Survey Doctor currently overlays equal-width display groupings on those numbers:
| Domain score | Product label | Total score | Product label |
|---|---|---|---|
| 0 | No distress | 0 | No distress |
| 0.01-25 | Mild distress | 0.01-75 | Mild distress |
| 25.01-50 | Moderate distress | 75.01-150 | Moderate distress |
| 50.01-75 | Significant distress | 150.01-225 | Significant distress |
| 75.01-100 | Severe distress | 225.01-300 | Severe distress |
The reviewed sources establish the score ranges, but not these baseline severity bands. Read the raw domains and total instead of treating a product label as a treatment threshold.
Labels do not prescribe care.
The three subscales
The domains separate three kinds of symptom bother.
POPDI-6: Pelvic organ prolapse distress inventory (questions 1-6)
Assesses symptoms related to pelvic organ prolapse including lower abdominal pressure, pelvic heaviness, vaginal bulging, and difficulty with bladder and bowel emptying related to prolapse.
CRADI-8: Colorectal-anal distress inventory (questions 7-14)
Assesses colorectal and anal symptoms including straining, incomplete bowel emptying, fecal incontinence (both formed and loose stool), gas incontinence, pain with defecation, bowel urgency, and rectal prolapse.
UDI-6: Urinary distress inventory (questions 15-20)
Assesses urinary symptoms including frequency, urgency-related leakage, stress-related leakage, small-amount leakage, difficulty emptying the bladder, and lower abdominal or genital pain.
Administration
The standard form asks about symptoms during the last three months and keeps symptom presence separate from reported bother.
Survey Doctor's current digital form omits that three-month stem, combines presence and bother into one answer, and requires all 20 responses. Equivalence with the reviewed source form has not been established. Treat results as specific to this implementation rather than interchangeable with a standard paper PFDI-20.
There is no universal repeat schedule. If a provider uses the questionnaire over time, follow the interval they choose and answer under similar conditions each time.
How scores are calculated
Published scoring takes the mean of answered items within each domain and multiplies by 25. A No response scores 0. This produces a 0-to-100 domain score, and the three domains sum to 0-300.
Missing responses affect the answered-item denominator. Follow the scoring method selected for that form instead of treating a blank response as zero.
Survey Doctor does not use that missing-item denominator for native administrations because all 20 answers are required.
Clinical applications
Clinicians can use the three domains to organize a conversation about symptom burden. Domain answers may be more informative than the total when one area accounts for most of the distress.
A score cannot show which treatment is appropriate or whether treatment caused a change. The measure record reports a 45-point change estimate from Barber's clinical sample. That context-specific figure is not a universal individual threshold or a subscale rule.
Evidence and validation
The 2005 development work used data from 100 women and then compared the short and long forms in an independent group of 45 women scheduled for pelvic floor surgery. Those samples support the short-form structure and responsiveness in defined clinical settings. They do not validate Survey Doctor's altered recall, one-step answers, or baseline bands.
Important considerations
- The source evidence concerns women with pelvic floor disorders
- One domain may carry most of the total
- Similar symptoms can produce different bother ratings
- Keep presence separate from bother when the form requires both
- Product bands are not care thresholds
- Treatment decisions need clinical context
Related assessments
Related assessment information
These pages cover related assessments. They may measure different constructs or use different populations and recall periods.
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