The number of adults using a long-term indwelling urinary catheter is increasing as populations age. Long-term catheter use is associated with substantial morbidity, including infections, leakage, pain, and a reduced quality of life [1]. The International Consultation on Incontinence Questionnaire - Long-Term Catheter Quality of Life (ICIQ-LTCqol) is a condition-specific patient-reported outcome measure (PROM) designed to assess catheter-related symptoms and quality of life in adults using a long-term indwelling urinary catheter (either urethral or suprapubic, for ≥3 months) [2]. 
Because a validated Dutch version was lacking for clinical practice and research, we aimed to translate the ICIQ-LTCqol into Dutch, and consequently cross-culturally validate this version.

The translation followed established cross-cultural adaptation procedures, including forward translation by three independent researchers fluent in English and Dutch, reconciliation through discussion, backward translation by a bilingual translator, approval by the ICIQ research group, and cognitive interviews to assess content validity. A subsequent cross-sectional validation study was conducted among adults using an indwelling transurethral or suprapubic catheter for ≥3 months. A subgroup completed the questionnaire again after approximately 14 days to assess test–retest reliability. 
Psychometric evaluation included exploratory factor analysis (EFA), internal consistency (Cronbach’s α), test–retest reliability (intraclass correlation coefficient, ICC), and assessment of floor and ceiling effects. Construct validity was evaluated by testing predefined hypotheses on correlations with the SF-Qualiveen and EuroQol 5-Dimension 5-Level (EQ-5D-5L). Internal consistency was considered adequate at α ≥ 0.70 and test-retest reliability at ICC ≥ 0.70 [3].

Ten cognitive interviews supported content validity of the Dutch translation. The validation study included 582 participants (mean age 75 years; 79% male; 50% suprapubic catheter), of whom 62 completed the questionnaire twice for test–retest reliability. 
EFA revealed a two-factor structure corresponding to the Catheter Function and Concern domain and the Lifestyle Impact domain, consistent with the original English version. Internal consistency was good for both domains (Catheter Function and Concern: α=0.76; Lifestyle Impact: α=0.73). Test-retest reliability was good for the Catheter Function and Concern domain (ICC=0.82, 95% CI 0.72–0.89) and borderline good for the Lifestyle Impact domain (ICC=0.69, 95% CI 0.53–0.80). All predefined hypotheses regarding construct validity were confirmed, with domain scores correlating in the expected directions with both the SF-Qualiveen and EQ-5D-5L. No floor or ceiling effects were observed.

The Dutch ICIQ-LTCqol demonstrated good measurement properties across all psychometric domains evaluated. The replication of the original two-factor structure, supported by good internal consistency, confirms the structural integrity and cross-cultural validity of the instrument. The difference in test-retest reliability between domains (good for Catheter Function and Concern and moderate for Lifestyle Impact) may reflect the greater sensitivity of lifestyle-related outcomes to short-term fluctuations in daily life, rather than true measurement instability. The absence of floor and ceiling effects confirms that the instrument captures the full spectrum of catheter-related burden, from minimal to severe impact. Together, these findings support the Dutch ICIQ-LTCqol as a psychometrically sound instrument for both cross-sectional and longitudinal assessment.

The Dutch ICIQ-LTCqol is a valid and reliable PROM for assessing catheter-related quality of life in Dutch-speaking adults with a long-term indwelling urethral or suprapubic catheter, suitable for use in both clinical practice and research.

Clark C, Haslam C, Malde S, Panicker JN. Urinary catheter management: what neurologists need to know. Pract Neurol. 2021;21(6):504–514.
Cotterill N, Fowler S, Avery M, Cottenden AM, Wilde M, Long A, Fader MJ. Development and psychometric evaluation of the ICIQ-LTCqol: a self-report quality of life questionnaire for long-term indwelling catheter users. Neurourol Urodyn. 2016;35(3):423–428.
Mokkink LB, Elsman E, Terwee CB. COSMIN manual for conducting systematic reviews of Patient-Reported Outcome Measures (PROMs). Version 2.0. Amsterdam: Amsterdam UMC; 2024. Available from: www.cosmin.nl.

Continence 19S (2026) 102718
DOI: 10.1016/j.cont.2026.102718