Abstract
The aim of this study was to assess the correlation between St. Mark’s incontinence score (SMIS) for anal incontinence and impact on quality of life (QoL), following primary repair of obstetric anal sphincter injuries (OASIS). Three hundred sixty-eight women who sustained OASIS completed a Manchester Health Questionnaire (MHQ) and the clinician calculated a SMIS. Spearman’s correlation coefficients were calculated, and Mann–Whitney U test was used to compare different severity subgroups. Mean follow-up was 10 weeks and mean age was 30 years. Mean SMIS was 1.35. All MHQ QoL domains showed statistically significant positive correlation with SMIS. When comparing SMIS subgroups (0–4, 5–8, >8), mean QoL domain scores were higher with increasing SMIS. This shows that the objective assessment of severity of anal incontinence, using the SMIS, correlates to its impact on QoL in a relatively young population with low severity of symptoms and can, therefore, be used in women who sustain OASIS.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Perry S, Shaw C, McGrother C, Matthews RJ, Assassa RP, Dallosso H et al (2002) Prevalence of faecal incontinence in adults aged 40 years or more living in the community. Gut 50:480–484
Vaizey CJ, Carapeti E, Cahill JA et al (1999) Prospective comparison of faecal incontinence grading systems. Gut 44:77–80
Rockwood TH, Church JM, Fleshman JW, Kane RL, Mavrantonis C, Thorson AG et al (1999) Patient and surgeon ranking of the severity of symptoms associated with fecal incontinence: the fecal incontinence severity index. Dis Colon Rectum 42:1525–1532
Pescatori M, Anastasio G, Bottini C et al (1992) New grading and scoring for anal incontinence. Evaluation of 335 patients. Dis Colon Rectum 35:482–487
Jorge JMN, Wexner SD (1993) Etiology and management of fecal incontinence. Dis Colon Rectum 36:77–97
Wong WD, Congliosi SM, Spencer MP, Corman ML, Tan P, Opelka FG et al (2002) The safety and efficacy of the artificial bowel sphincter for fecal incontinence. Dis Colon Rectum 45:1139–1153
Deutekom M, Terra MP, Dobben AC, Dijkgraaf MGW, Baeten CGMI, Stoker J et al (2005) Impact of faecal incontinence severity on health domains. Colorectal Dis 7:263–269
Maeda Y, Parés D, Norton C et al (2008) Does the St. Mark’s incontinence score reflect patients’ perceptions? A review of 390 patients. Dis Colon Rectum 51:436–442
Boreham MK, Richter HE, Kenton KS, Nager CW, Gregory WT, Aronson MP et al (2005) Anal incontinence in women presenting for gynaecologic care: prevalence, risk factors, and impact upon quality of life. Am J Obstet Gynecol 192:1637–1642
Rothbarth J, Bemelman WA, Meijerink WJHJ, Stiggelbout AM, Zwinderman AH, Buyze-Westerweel ME et al (2001) What is the impact of fecal incontinence on quality of life? Dis Colon Rectum 44:67–71
Fenech DS, Takahashi T, Liu M, Spencer L, Swallow CJ, Cohen Z et al (2007) Function and quality of life after transanal excision of rectal polyps and cancers. Dis Colon Rectum 50:598–603
Lehur PA, Zerbib F, Neunlist M et al (2002) Comparison of quality of life and anorectal function after artificial sphincter implantation. Dis Colon Rectum 45:508–513
Pla-Martí V, Moro-Valdezate D, Alos-Company R et al (2007) The effect of surgery on quality of life in patients with faecal incontinence of obstetric origin. Colorectal Dis 9:90–95
Hatem M, Fraser W, Lepire E (2005) Postpartum urinary and anal incontinence: a population-based study of quality of life of primiparous women in Quebec. J Obstet Gynaecol Can 27:682–688
Handa VL, Zyczynski HM, Burgio KL, Fitzgerald MP, Borello-France D, Jnaz NK et al (2007) The impact of fecal and urinary incontinence on quality of life 6 months after childbirth. Am J Obstet Gynecol 197:636.e1–636.e6
Bugg GJ, Kiff ES, Hosker G (2001) A new condition-specific health-related quality of life questionnaire for the assessment of women with anal incontinence. BJOG 108:1057–1067
Sultan AH, Thakar R (2007) Third and fourth degree tears. In: Sultan AH, Thakar R, Fenner DE (eds) Perineal and anal sphincter trauma. Springer, London, pp 33–51
Mahony R, Behan M, Daly L, Kirwan C, O’Herlihy C, O’Connell PR (2007) Internal anal sphincter defect influences continence outcome following obstetric anal sphincter injury. Am J Obstet Gynecol 196:217.e1–217.e5
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Roos, AM., Sultan, A.H. & Thakar, R. St. Mark’s incontinence score for assessment of anal incontinence following obstetric anal sphincter injuries (OASIS). Int Urogynecol J 20, 407–410 (2009). https://doi.org/10.1007/s00192-008-0784-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-008-0784-7