title: The bother of anal incontinence and St. Mark's Incontinence Score.
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.
authors.affiliation: Sydney Medical School Nepean, Nepean Hospital, Penrith, NSW, 2750, Australia.|Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: C
authors.initials: C
authors.lastname: Paka
authors.affiliation: Sydney Medical School Nepean, Nepean Hospital, Penrith, NSW, 2750, Australia.|Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: I K
authors.initials: IK
authors.lastname: Atan
authors.affiliation: Sydney Medical School Nepean, Nepean Hospital, Penrith, NSW, 2750, Australia. hpdietz2@bigpond.com.
authors.forename: H P
authors.initials: HP
authors.lastname: Dietz
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000503:physiopathology; D005242:Fecal Incontinence / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D011788:Quality of Life; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D064232:Visual Analog Scale
keywords: Anal incontinence; Fecal incontinence; St. Mark’s Incontinence Score; Visual analogue scale