OBJECTIVES: The Incontinence Quality of life Questionnaire (I-QOL) is a 22-item questionnaire used in patients with urinary incontinence. Validity of the I-QOL has been demonstrated in stress incontinence patients. The purpose of this study is to assess I-QOL in patients with detrusor hyperreflexia. METHODS: Data were from a multicenter, double-blind, randomized, placebo-controlled, parallel group study of two Botox doses. The I-QOL was scored according to the developer's guidelines which provide total score and three domain scores: avoidance and limiting behavior (ALB), psychosocial impact (PS), social embarrassment (SE). Validity and reliability were assessed by item to scale correlations, similarity of means and variance, reliability (Cronbach's alpha), floor and ceiling effects, and correlations with clinical measures. Responsiveness was assessed by evaluation of I-QOL scores for all groups. RESULTS: The majority of patients (n=56) were Caucasian (93%) and male (59%). All but four items of the 22 I-QOL items were more highly correlated with their hypothesized scale than with competing scales; however most of the items failed to meet a criterion of “two standard errors greater”. Item means and variances were similar for the PS and SE domains. The ALB items exhibited similar variances; however range in means was somewhat larger. Cronbach's alpha ranged from 0.79 to 0.89 for domains and 0.93 for the total. There was no significant floor or ceiling effect. Moderate correlations (0.18 to 0.37) existed between I-QOL scores and clinical measures (e.g., number of involuntary losses of urine, and urodynamic parameters). CONCLUSIONS: The validity of the I-QOL in this neurogenic bladder population is supported. The ALB domain was not as consistent since there was a mix of detrusor hyperreflexia patients in this study and one question may not be as relevant for some patients. Additional study in larger samples is warranted.