Assessment Tool: ICIQ-SF
The ICIQ-SF is a validated patient-reported tool for assessing the frequency, severity, and quality-of-life impact of urinary incontinence. Items 1–3 produce a scored total (0–21); Item 4 identifies incontinence type (stress, urge, mixed, or functional) and is recorded but not scored. Use findings to guide pelvic floor rehabilitation, behavioral management, and referral decisions.
ICIQ-SF — International Consultation on Incontinence Questionnaire (Short Form)
A validated 4-item patient-completed screening and outcome tool assessing the frequency, severity, and impact on quality of life of urinary incontinence. Scored items 1–3 produce a total of 0–21. Item 4 is descriptive only. Developed by the International Consultation on Incontinence.
Score interpretation (items 1–3 combined)
0
No incontinence
1–5
Slight
6–12
Moderate
13–21
Severe–Very severe
Result
ICIQ-SF Score: 0/21
Severity:
Review Item 4 responses with the patient to identify incontinence type. Document findings and discuss with provider to guide pelvic floor physical therapy, behavioral modifications, pharmacological treatment, or urological referral.