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Published in: Techniques in Coloproctology 2/2016

01-02-2016 | Short Communication

The bother of anal incontinence and St. Mark’s Incontinence Score

Authors: C. Paka, I. K. Atan, H. P. Dietz

Published in: Techniques in Coloproctology | Issue 2/2016

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Abstract

Background

Patient self-report is important in the assessment of the impact of anal incontinence (AI) on quality of life. This study aimed to (1) determine the correlation between total St. Mark’s Incontinence Score (SMIS) and a single-item visual analogue scale (VAS) for bother from AI, and (2) determine the correlation between individual components of SMIS and VAS.

Methods

This is a retrospective study conducted on a cohort of 516 women seen for symptoms of lower urinary tract and pelvic floor dysfunction between January 2013 and August 2014. If a woman responded “yes” to the question “Do you experience any leakage from the back passage/anus?” they were considered to have AI, and the SMIS was administered. They were also asked “How much are you bothered by these symptoms?” to assess bother from AI by VAS. Statistical analyses were performed using Spearman’s correlation and Mann–Whitney U test.

Results

Eighty-four (16.3 %) women reported AI with a mean SMIS of 11 (SD ± 5.11, range 2–24) and median bother of 5 (VAS 1–10). There was a fair correlation between VAS for the bother from AI and SMIS (Spearman’s r = 0.523, p < 0.001). Fecal urgency, impact on lifestyle, and use of pad/plug were significantly associated with VAS (p = 0.05, p = 0.002 and p < 0.001, respectively).

Conclusions

There is a fair, positive correlation between VAS for bother from AI and SMIS. Patients’ bother from AI is strongly associated with its impact on lifestyle as quantified by individual SMIS components.
Literature
1.
go back to reference Haylen BT, de Ridder D, Freeman RM et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 29:4–20PubMed Haylen BT, de Ridder D, Freeman RM et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 29:4–20PubMed
2.
go back to reference Bharucha AE, Dunivan G, Goode PS et al (2015) Epidemiology, pathophysiology, and classification of fecal incontinence: state of the science summary for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) workshop. Am J Gastroenterol 110:127–136PubMedPubMedCentralCrossRef Bharucha AE, Dunivan G, Goode PS et al (2015) Epidemiology, pathophysiology, and classification of fecal incontinence: state of the science summary for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) workshop. Am J Gastroenterol 110:127–136PubMedPubMedCentralCrossRef
3.
go back to reference Whitehead WE (2005) Diagnosing and managing fecal incontinence: if you don’t ask, they won’t tell. Gastroenterology 129:6PubMedCrossRef Whitehead WE (2005) Diagnosing and managing fecal incontinence: if you don’t ask, they won’t tell. Gastroenterology 129:6PubMedCrossRef
4.
go back to reference Bharucha AE, Zinsmeister AR, Locke GR et al (2005) Prevalence and burden of fecal incontinence: a population-based study in women. Gastroenterology 129:42–49PubMedCrossRef Bharucha AE, Zinsmeister AR, Locke GR et al (2005) Prevalence and burden of fecal incontinence: a population-based study in women. Gastroenterology 129:42–49PubMedCrossRef
5.
go back to reference Sung VW, Hampton BS (2009) Epidemiology of pelvic floor dysfunction. Obstet Gynecol Clin North Am 36:421–443PubMedCrossRef Sung VW, Hampton BS (2009) Epidemiology of pelvic floor dysfunction. Obstet Gynecol Clin North Am 36:421–443PubMedCrossRef
7.
go back to reference Goode PS, Burgio KL, Halli AD et al (2005) Prevalence and correlates of fecal incontinence in community-dwelling older adults. J Am Geriatr Soc 53:629–635PubMedCrossRef Goode PS, Burgio KL, Halli AD et al (2005) Prevalence and correlates of fecal incontinence in community-dwelling older adults. J Am Geriatr Soc 53:629–635PubMedCrossRef
8.
go back to reference Melville JL, Fan MY, Newton K, Fenner D (2005) Fecal incontinence in US women: a population-based study. Am J Obstet Gynecol 193:2071–2076PubMedCrossRef Melville JL, Fan MY, Newton K, Fenner D (2005) Fecal incontinence in US women: a population-based study. Am J Obstet Gynecol 193:2071–2076PubMedCrossRef
9.
go back to reference Nelson R, Norton N, Cautley E, Furner S (1995) Community-based prevalence of anal incontinence. JAMA 274:559–561PubMedCrossRef Nelson R, Norton N, Cautley E, Furner S (1995) Community-based prevalence of anal incontinence. JAMA 274:559–561PubMedCrossRef
10.
11.
12.
go back to reference Meschia M, Buonaguidi A, Pifarotti P, Somigliana E, Spennacchio M, Amicarelli F (2002) Prevalence of anal incontinence in women with symptoms of urinary incontinence and genital prolapse. Obstet Gynecol 100:719–723PubMedCrossRef Meschia M, Buonaguidi A, Pifarotti P, Somigliana E, Spennacchio M, Amicarelli F (2002) Prevalence of anal incontinence in women with symptoms of urinary incontinence and genital prolapse. Obstet Gynecol 100:719–723PubMedCrossRef
13.
go back to reference Soligo M, Salvatore S, Milani R et al (2003) Double incontinence in urogynecologic practice: a new insight. Am J Obstet Gynecol 189:438–443PubMedCrossRef Soligo M, Salvatore S, Milani R et al (2003) Double incontinence in urogynecologic practice: a new insight. Am J Obstet Gynecol 189:438–443PubMedCrossRef
14.
go back to reference de Mello Portella P, Feldner PC Jr, da Conceicao JC, Castro RA, Sartori MG, Girao MJ (2012) Prevalence of and quality of life related to anal incontinence in women with urinary incontinence and pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol 160:228–231CrossRef de Mello Portella P, Feldner PC Jr, da Conceicao JC, Castro RA, Sartori MG, Girao MJ (2012) Prevalence of and quality of life related to anal incontinence in women with urinary incontinence and pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol 160:228–231CrossRef
15.
go back to reference Cotterill N, Norton C, Avery KN, Abrams P, Donovan JL (2008) A patient-centered approach to developing a comprehensive symptom and quality of life assessment of anal incontinence. Dis Colon Rectum 51:82–87PubMedCrossRef Cotterill N, Norton C, Avery KN, Abrams P, Donovan JL (2008) A patient-centered approach to developing a comprehensive symptom and quality of life assessment of anal incontinence. Dis Colon Rectum 51:82–87PubMedCrossRef
16.
go back to reference Johanson JF, Lafferty J (1996) Epidemiology of fecal incontinence: the silent affliction. Am J Gastroenterol 91:33–36PubMed Johanson JF, Lafferty J (1996) Epidemiology of fecal incontinence: the silent affliction. Am J Gastroenterol 91:33–36PubMed
17.
go back to reference Brown HW, Wexner SD, Segall MM, Brezoczky KL, Lukacz ES (2012) Quality of life impact in women with accidental bowel leakage. Int J Clin Pract 66:1109–1116PubMedCrossRef Brown HW, Wexner SD, Segall MM, Brezoczky KL, Lukacz ES (2012) Quality of life impact in women with accidental bowel leakage. Int J Clin Pract 66:1109–1116PubMedCrossRef
18.
go back to reference Drossman DA, Li Z, Andruzzi E et al (1993) U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci 38:1569–1580PubMedCrossRef Drossman DA, Li Z, Andruzzi E et al (1993) U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci 38:1569–1580PubMedCrossRef
19.
go back to reference Nyrop KA, Grover M, Palsson OS et al (2012) Likelihood of nursing home referral for fecally incontinent elderly patients is influenced by physician views on nursing home care and outpatient management of fecal incontinence. J Am Med Dir Assoc 13:350–354PubMedPubMedCentralCrossRef Nyrop KA, Grover M, Palsson OS et al (2012) Likelihood of nursing home referral for fecally incontinent elderly patients is influenced by physician views on nursing home care and outpatient management of fecal incontinence. J Am Med Dir Assoc 13:350–354PubMedPubMedCentralCrossRef
20.
go back to reference Thekkinkattil DK, Lim M, Finan PJ, Sagar PM, Burke D (2008) Awareness of investigations and treatment of faecal incontinence among the general practitioners: a postal questionnaire survey. Colorectal Dis 10:263–267PubMedCrossRef Thekkinkattil DK, Lim M, Finan PJ, Sagar PM, Burke D (2008) Awareness of investigations and treatment of faecal incontinence among the general practitioners: a postal questionnaire survey. Colorectal Dis 10:263–267PubMedCrossRef
21.
go back to reference Bliss DZ, Norton C, Vodusek DB (2010) Raising awareness about fecal incontinence. Neurourol Urodyn 29:612–615PubMedCrossRef Bliss DZ, Norton C, Vodusek DB (2010) Raising awareness about fecal incontinence. Neurourol Urodyn 29:612–615PubMedCrossRef
22.
go back to reference Boreham MK, Richter HE, Kenton KS et al (2005) Anal incontinence in women presenting for gynecologic care: prevalence, risk factors, and impact upon quality of life. Am J Obstet Gynecol 192:1637–1642PubMedCrossRef Boreham MK, Richter HE, Kenton KS et al (2005) Anal incontinence in women presenting for gynecologic care: prevalence, risk factors, and impact upon quality of life. Am J Obstet Gynecol 192:1637–1642PubMedCrossRef
23.
go back to reference Dunivan GC, Heymen S, Palsson OS et al (2010) Fecal incontinence in primary care: prevalence, diagnosis, and health care utilization. Am J Obstet Gynecol 202:493PubMedCrossRef Dunivan GC, Heymen S, Palsson OS et al (2010) Fecal incontinence in primary care: prevalence, diagnosis, and health care utilization. Am J Obstet Gynecol 202:493PubMedCrossRef
25.
go back to reference Maeda Y, Pares D, Norton C, Vaizey CJ, Kamm MA (2008) Does the St. Mark’s incontinence score reflect patients’ perceptions? A review of 390 patients. Dis Colon Rectum 51:436–442PubMedCrossRef Maeda Y, Pares D, Norton C, Vaizey CJ, Kamm MA (2008) Does the St. Mark’s incontinence score reflect patients’ perceptions? A review of 390 patients. Dis Colon Rectum 51:436–442PubMedCrossRef
26.
go back to reference Roos AM, Sultan AH, Thakar R (2009) St. Mark’s incontinence score for assessment of anal incontinence following obstetric anal sphincter injuries (OASIS). Int Urogynecol J Pelvic Floor Dysfunct 20:407–410PubMedCrossRef Roos AM, Sultan AH, Thakar R (2009) St. Mark’s incontinence score for assessment of anal incontinence following obstetric anal sphincter injuries (OASIS). Int Urogynecol J Pelvic Floor Dysfunct 20:407–410PubMedCrossRef
27.
go back to reference Lukacz ES, Lawrence JM, Burchette RJ, Luber KM, Nager CW, Buckwalter JG (2004) The use of Visual Analog Scale in urogynecologic research: a psychometric evaluation. Am J Obstet Gynecol 191:165–170PubMedCrossRef Lukacz ES, Lawrence JM, Burchette RJ, Luber KM, Nager CW, Buckwalter JG (2004) The use of Visual Analog Scale in urogynecologic research: a psychometric evaluation. Am J Obstet Gynecol 191:165–170PubMedCrossRef
28.
go back to reference Stach-Lempinen B, Kujansuu E, Laippala P, Metsanoja R (2001) Visual analogue scale, urinary incontinence severity score and 15 D-psychometric testing of three different health-related quality-of-life instruments for urinary incontinent women. Scand J Urol Nephrol 35:476–483PubMedCrossRef Stach-Lempinen B, Kujansuu E, Laippala P, Metsanoja R (2001) Visual analogue scale, urinary incontinence severity score and 15 D-psychometric testing of three different health-related quality-of-life instruments for urinary incontinent women. Scand J Urol Nephrol 35:476–483PubMedCrossRef
29.
go back to reference Trutnovsky G, Ulrich D, Rojas RG, Mann K, Aigmueller T, Dietz HP (2014) The “bother” of urinary incontinence. Int Urogynecol J 25:947–951PubMedCrossRef Trutnovsky G, Ulrich D, Rojas RG, Mann K, Aigmueller T, Dietz HP (2014) The “bother” of urinary incontinence. Int Urogynecol J 25:947–951PubMedCrossRef
30.
go back to reference Ulrich D, Guzman Rojas R, Dietz HP, Mann K, Trutnovsky G (2014) Use of a visual analog scale for evaluation of bother from pelvic organ prolapse. Ultrasound Obstet Gynecol 43:693–697PubMedCrossRef Ulrich D, Guzman Rojas R, Dietz HP, Mann K, Trutnovsky G (2014) Use of a visual analog scale for evaluation of bother from pelvic organ prolapse. Ultrasound Obstet Gynecol 43:693–697PubMedCrossRef
31.
go back to reference Devesa JM, Vicente R, Abraira V (2013) Visual analogue scales for grading faecal incontinence and quality of life: their relationship with the Jorge–Wexner score and Rockwood scale. Tech Coloproctol 17:67–71PubMedCrossRef Devesa JM, Vicente R, Abraira V (2013) Visual analogue scales for grading faecal incontinence and quality of life: their relationship with the Jorge–Wexner score and Rockwood scale. Tech Coloproctol 17:67–71PubMedCrossRef
32.
go back to reference Harvie HS, Arya LA, Saks EK, Sammel MD, Schwartz JS, Shea JA (2011) Utility preference score measurement in women with fecal incontinence. Am J Obstet Gynecol 204:72e1-6CrossRef Harvie HS, Arya LA, Saks EK, Sammel MD, Schwartz JS, Shea JA (2011) Utility preference score measurement in women with fecal incontinence. Am J Obstet Gynecol 204:72e1-6CrossRef
33.
go back to reference Dietz HP (2004) Ultrasound imaging of the pelvic floor. Part II: three-dimensional or volume imaging. Ultrasound Obstet Gynecol 23:615–625PubMedCrossRef Dietz HP (2004) Ultrasound imaging of the pelvic floor. Part II: three-dimensional or volume imaging. Ultrasound Obstet Gynecol 23:615–625PubMedCrossRef
34.
go back to reference Shek KL, Guzman-Rojas R, Dietz HP (2014) Residual defects of the external anal sphincter following primary repair: an observational study using transperineal ultrasound. Ultrasound Obstet Gynecol 44:704–709PubMedCrossRef Shek KL, Guzman-Rojas R, Dietz HP (2014) Residual defects of the external anal sphincter following primary repair: an observational study using transperineal ultrasound. Ultrasound Obstet Gynecol 44:704–709PubMedCrossRef
35.
go back to reference Kaiser AM, Orangio GR, Zutshi M et al (2014) Current status: new technologies for the treatment of patients with fecal incontinence. Surg Endosc 28:2277–2301PubMedCrossRef Kaiser AM, Orangio GR, Zutshi M et al (2014) Current status: new technologies for the treatment of patients with fecal incontinence. Surg Endosc 28:2277–2301PubMedCrossRef
36.
go back to reference Van Koughnett JA, Wexner SD (2013) Current management of fecal incontinence: choosing amongst treatment options to optimize outcomes. World J Gastroenterol 19:9216–9230PubMedPubMedCentralCrossRef Van Koughnett JA, Wexner SD (2013) Current management of fecal incontinence: choosing amongst treatment options to optimize outcomes. World J Gastroenterol 19:9216–9230PubMedPubMedCentralCrossRef
37.
go back to reference Menees SB, Smith TM, Xu X, Chey WD, Saad RJ, Fenner DE (2013) Factors associated with symptom severity in women presenting with fecal incontinence. Dis Colon Rectum 56:97–102PubMedCrossRef Menees SB, Smith TM, Xu X, Chey WD, Saad RJ, Fenner DE (2013) Factors associated with symptom severity in women presenting with fecal incontinence. Dis Colon Rectum 56:97–102PubMedCrossRef
38.
go back to reference Deutekom M, Terra MP, Dobben AC et al (2005) Impact of faecal incontinence severity on health domains. Colorectal Dis 7:263–269PubMedCrossRef Deutekom M, Terra MP, Dobben AC et al (2005) Impact of faecal incontinence severity on health domains. Colorectal Dis 7:263–269PubMedCrossRef
39.
go back to reference Sansoni J, Hawthorne G, Fleming G, Marosszeky N (2013) The revised faecal incontinence scale: a clinical validation of a new, short measure for assessment and outcomes evaluation. Dis Colon Rectum 56:652–659PubMedCrossRef Sansoni J, Hawthorne G, Fleming G, Marosszeky N (2013) The revised faecal incontinence scale: a clinical validation of a new, short measure for assessment and outcomes evaluation. Dis Colon Rectum 56:652–659PubMedCrossRef
40.
Metadata
Title
The bother of anal incontinence and St. Mark’s Incontinence Score
Authors
C. Paka
I. K. Atan
H. P. Dietz
Publication date
01-02-2016
Publisher
Springer Milan
Published in
Techniques in Coloproctology / Issue 2/2016
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-015-1397-z

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