International Urogynecology Journal

, Volume 27, Issue 6, pp 959–963 | Cite as

Cultural adaptation and validation of the Wexner scale in patients with anal incontinence in a Brazilian population

  • Andrea Moura Fonseca
  • Mariana Furtado Meinberg
  • Débora Vianna Lucas
  • Marilene Vale Monteiro
  • Elyonara Mello Figueiredo
  • Leonardo Fonseca
  • Agnaldo Lopes Filho
Original Article


Introduction and hypothesis

Jorge and Wexner devised a questionnaire for anal incontinence (AI), known as the Wexner scale (WS). Specific validated questionnaires are essential for the assessment of symptom severity. The objective was to accomplish the cultural adaptation and validation of the Portuguese version of the WS.


The WS was validated according to the international criteria. A Brazilian version was tested, including the item “I do not understand” at the end of each question. If this answer was reported at a rate higher than 15 %, the item would be considered difficult to understand and would thus be modified. The final version of the WS and the Fecal Incontinence Quality of Life (FIQL) were completed by 50 women. Convergent validity was assessed by comparing the data from the first interview of the WS with the FIQL using Spearman’s test. Reproducibility was assessed by means of a 2-week test–retest procedure using Cronbach’s alpha coefficient.


In the initial version of the questionnaire, we did not obtain a response of “I do not understand” at a rate greater than 15 % and this version was considered definitive. A significant negative relationship (r = −0.63) was found between the FIQL total score and the WS. The answers obtained on the “test–re-est” questionnaires showed a significant correlation according to the intraclass correlation coefficient (ICC). A high level of internal consistency was found, as demonstrated by a Cronbach’s alpha of 0.932.


The Brazilian Portuguese version of the WS is a reliable, consistent, and valid instrument.


Fecal incontinence Quality of life Wexner scale Validation 


Compliance with ethical standards

Conflicts of interest



Minas Gerais Foundation of Support Research (FAPEMIG).


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Copyright information

© The International Urogynecological Association 2015

Authors and Affiliations

  • Andrea Moura Fonseca
    • 1
  • Mariana Furtado Meinberg
    • 1
  • Débora Vianna Lucas
    • 2
  • Marilene Vale Monteiro
    • 1
  • Elyonara Mello Figueiredo
    • 3
  • Leonardo Fonseca
    • 4
  • Agnaldo Lopes Filho
    • 1
  1. 1.Section of Urogynecology, Department of Gynecology and ObstetricsUniversidade Federal de Minas GeraisBelo HorizonteBrazil
  2. 2.Minas Gerais foundation of support research (FAPEMIG)Belo HorizonteBrazil
  3. 3.Section of Urogynecology, Department of PhysiotherapyUniversidade Federal de Minas GeraisBelo HorizonteBrazil
  4. 4.Division of Colorectal Surgery of the Alfa Institute of Gastroenterology at the University Hospital of the Universidade Federal de Minas GeraisBelo HorizonteBrazil

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