Yes / Research Question: To assess the feasibility of the MGSIS-5and G3L-20 in a community sample of cisgender men aged 40 years and older Research problem: Psychometric measures can aid urologic practice by prompting patients to talk about aspects of their body that are either too sensitive or a natural part of aging. Importantly, reliable and valid measures can also contribute to a an evidenced-based-practice-based-evidence cycle where they can establish the impact of changes recommended by research while using the results in turn to inform research. In this study, we examine two psychometric measures on the opposite ends of a psychological-physical continuum; the Male Genital Self-Image Scale (MGSIS-5) and the Groin and Lower Limb Lymphedema questionnaire (G3L-20) Methodology: Non-experimental psychometric design administering the questionnaires online to a community sample of cisgender men aged 40 years old and above. Validity and reliability analyses were conducted. Results: 30 men completed the study; 14 aged 40-49, 14 aged 50-59 and 2 aged 60-69. The MGSIS-5 and G3L-20 show acceptable reliability and validity with one- and three-component structures respectively. Conclusions: The MGSIS-5 and G3L-20 show sufficient feasibility to justify the resources for studies with larger community samples and for pilot studies with clinical populations.

Severe perineal trauma with injury to the anal sphincter at childbirth can have a profound effect on the physical and psychological wellbeing of women. This thesis describes literature examining resulting outcomes including effects on body image. It describes patient-based outcome measures used to capture this information, and evaluation of their psychometric properties. Body Image can be defined as an individual's perceptions and feelings about their own body. There is a growing interest in how this concept can influence quality of life and psychosocial dysfunction in medical disorders. This thesis aimed to examine relationships between severity of perineal trauma, general and genital specific body image and potentially influences such as symptoms of pelvic floor dysfunction. No patient-reported outcome measure validated for use in women after anal sphincter injury exists and this thesis also aimed to psychometrically evaluate an existing electronic questionnaire, ePAQ (electronic personal assessment questionnaire), for this application. In the thesis, a retrospective review of body image and physical outcomes attending a perineal clinic shows over half of women report perceived changes in body image after anal sphincter injury, with negative effects on self-esteem. A prospective observational cohort study explored genital and general body image in primiparous women grouped according to degree of perineal trauma or caesarean delivery. Women completed the Female Genital Self Image Score, the modified Body Image Score, ePAQ and the Edinburgh Postnatal Depression Scale a mean of 15.5 weeks (standard deviation 1.6) after delivery. There were significant differences in genital body image scores between the groups, but not in general body image, with regression analysis showing the greatest influence on genital body image to be the anatomical extent of the trauma. Embedded into this study was the evaluation of reliability (internal consistency and test-retest) and validity (face, content and construct) of ePAQ in the group of women with anal sphincter tears. This thesis presents the first research to quantify issues surrounding severe perineal trauma and body image and demonstrates that more severe trauma leads to a poorer genital body image. It also reports psychometric evaluation of ePAQ in women after anal sphincter injury providing the first single instrument with validity and reliability for use in this context.

Yes / When used in routine clinical practice, Patient Reported Outcomes Measures (PROMS) can give patients tacit approval to discuss embarrassing topics, which could be particularly useful for urological nursing. The aim of this study was to assess whether it would be feasible to use two such measures for penile cancer; one for body image (the Male Genital Self-Image Scale; MGSIS-5) and another for lymphedema (the Groin and Lower Limb Lymphedema questionnaire; G3L-20). Study packs were posted to penile cancer patients who had received (i) sentinel node biopsy only, (ii) inguinal node dissection only, and (iii) inguinal node dissection with post-operative radiotherapy with or without chemotherapy. The two measures (MGSIS-5 and G3L-20) were complemented with those specific to sexual function (IIEF) and cancer (EORTC-QLQ-C30 version 3) and a modified Lymphoedema Genitourinary Cancer Questionnaire (mLGUCQ). Twenty patients returned questionnaires. Validity and reliability analyses are presented but low participant numbers mean that results need treating with caution. Results show sufficient feasibility for the MGSIS-5 and the G3L-20 to warrant another study to attract larger numbers of participants, either over a longer time frame or at multiple sites. In these further studies, we would recommend adding (1) more Likert responses, (2) the timeframe to the MGIS and (3) exploring either the use of sexual desire psychometric measures or the addition of sexual desire items to the MGSIS for this patient group.