St. Mark's incontinence score for assessment of anal incontinence following obstetric anal sphincter injuries (OASIS)

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.