Translation

The validation process of a linguistic translation must maintain conceptual and technical equivalence between the source and target language [5]. The questionnaire was translated into Italian by the following procedural steps [6]. A preliminary translation from English into Italian was carried out in parallel by two native Italian-speaking translators, with English as their first foreign language. Then, a consensus meeting among translators and the research group was held to compare the two Italian versions and yielded a first consensus Italian version of the questionnaire. After that, a native English-speaking translator with Italian as his first foreign language back-translated the Italian consensus version. A second consensus meeting was held between the English mother-tongue translator and clinical investigators, during which the back-translated and original questionnaires were compared and differences discussed. The process led to a revised version of the first consensus questionnaire. The comprehension of the obtained Italian consensus version was therefore tested in a real-life population to assess questionnaire comprehension. The questionnaire was submitted to a group of ten women referred to urogynecology outpatient clinic for pelvic organ prolapse or urinary incontinence, after standard evaluation including obstetric and gynecological history collection, medical interview, and urogynecological examination, as previously described [7]. They were asked to evaluate their perceived degree of difficulty in understanding each question item, and unstructured feedback was collected. All women correctly understood questions and precoded answers and no item was therefore changed. After that, the final Italian version of the questionnaire was obtained (Supplemental Material 1).