Comparison of clinical methods for the assessment of continence after repair of high anorectal anomalies

Abstract

Fifty-six patients with high anorectal anomalies treated by anorectoplasty at the Royal Children's Hospital, Melbourne were assessed clinically after 5–32 years. Each patient was graded by the Kelly, Templeton, Kiesewetter, and Wingspread continence scoring methods. Grades of continence assessed by each method had substantial or excellent concordance, although the Templeton “faecal continence score” assigned a higher grade of anorectal continence than the other three. The Wingspread system was useful for monitoring the current status of the individual patient and continued dependence on therapy, but its complex and descriptive nature made it difficult to use in comparisons between series. The Kelly scoring method involves digital examination of the rectum but is simple to apply, and gave as good an indication of the functional level of anorectal continence as the other schemes.