Set‐up and statistical validation of a new scoring system for obstructed defaecation syndrome

Altomare, D. F.; Spazzafumo, Liana; Rinaldi, Marcella; Dodi, Giuseppe; Ghiselli, Roberto; Piloni, V.

doi:10.1111/j.1463-1318.2007.01262.x

Cited by 243 publications

(141 citation statements)

References 14 publications

(12 reference statements)

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“…Eventually, 103 patients with clinically significant rectocele were selected to analyze the efficacy of clinical treatment, clinical treatment combined with biofeedback therapy, and surgical repair. Although a specific scoring system for obstructed defecation syndrome has been proposed (2,19) , at our institution, Wexner's constipation score has been widely used in investigations involving functional constipation symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Proper treatment requires the identification of all associated dysfunctions and the quantification of symptoms (most often excessive straining, feeling of incomplete evacuation, difficult evacuation, infrequent evacuation and the need for digitally assisted evacuation) by means of a scoring system (1,2,19) . Obstructed defecation syndrome is associated with anatomic changes (rectocele, intussusception, mucosal prolapse and perineal descent) and∕or functional changes (non-relaxation or paradoxical contraction/ anismus) a complete clinical investigation is required, if possible with techniques capable of identifying all dysfunctions.…”

Section: Introductionmentioning

confidence: 99%

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Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

Murad-Regadas

Regadas

Rodrigues

et al. 2012

Arq. Gastroenterol.

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-Context -Management of patients with obstructed defecation syndrome is still controversial. Objective -To analyze the efficacy of clinical, clinical treatment followed by biofeedback, and surgical treatment in patients with obstructed defecation, rectocele and multiple dysfunctions evaluated with echodefecography. Methods -The study included 103 females aged 26-84 years with obstructed defecation, grade-II/III rectocele and multiple dysfunctions on echodefecography. Patients were distributed into three treatment groups and constipation scores were assigned. Group I: 34 (33%) patients with significant improvement of symptoms through clinical management only. Group II: 14 (14%) with improvement through clinical treatment plus biofeedback. Group III: 55 (53%) referred to surgery due to treatment failure. Results -Group I: 20 (59%) patients had grade-II rectocele, 14 (41%) grade-III. Obstructed defecation syndrome was associated with intussusception (41%), mucosal prolapse (41%), anismus (29%), enterocele (9%) or 2 dysfunctions (23%). The average constipation score decreased significantly from 11 to 5. Group II: 11 (79%) grade-II rectocele, 3 (21%) grade-III, associa ted with intussusception (7%), mucosal prolapse (43%), anismus (71%) or 2 dysfunctions (29%). There was significant decrease in constipation score from 13 to 6. Group III: 8 (15%) grade-II rectocele, 47 (85%) grade-III, associated with intussusception (42%), mucosal prolapse (40%) or 2 dysfunctions (32%). The constipation score remained unchanged despite clinical treatment and biofeedback. Twenty-three underwent surgery had a significantly decrease in constipation score from 12 to 4. The remaining 32 (31%) patients which 22 refused surgery, 6 had low anal pressure and 4 had slow transit. Conclusions -Approximately 50% of patients with obstructed defecation, rectocele and multiple dysfunctions presented a satisfactory response to clinical treatment and/or biofeedback. Surgical repair was mainly required in patients with grade-III rectocele whose constipation scores remained high despite all efforts. HEADINGS -Rectocele. Constipation. Pelvic floor. Imaging, three-dimensional.None disclosure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

Murad-Regadas

Regadas

Rodrigues

et al. 2012

Arq. Gastroenterol.

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“…Therefore ODS diagnosis involves great complexity and important direct and indirect costs. A clinical score is a useful tool to categorize the severity of symptoms and evaluate post-treatment results (8,9) . Besides, it can be studied as first line evaluation instrument before step up to a more complex diagnostic approach.…”

Section: Introductionmentioning

confidence: 99%

Renzi Score for Obstructed Defecation Syndrome - Validation of the Portuguese Version According to the Cosmin Checklist

Caetano

Dias

Cruz

et al. 2018

Arq. Gastroenterol.

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-Background -Recently, the Obstructed Defecation Syndrome score (ODS score) was developed and validated by Renzi to assess clinical staging and to allow evaluation and comparison of the efficacy of treatment of this disorder. Objective -Our goal is to validate the Portuguese version of Renzi ODS score, according to the Consensus based Standards for the selection of the Health Measurement Instruments (COSMIN) checklist. Methods -Following guidelines for cross-cultural validity, Renzi ODS score was translated into the Portuguese language. Then, a group of patients and healthy controls were invited to fill in the Renzi ODS score at baseline, after 2 weeks and 3 months, respectively. We assessed internal consistency, reliability and measurement error, content and construct validity, responsiveness and interpretability. Results -A total of 113 individuals (77 patients; 36 healthy controls) completed the questionnaire. Seventy and 30 patients repeated the Renzi ODS score after 2 weeks and 3 months respectively. Factor analysis confirmed the unidimensionality of the scale. Cronbach's α coefficient of 0.77 supported item's homogeneity. Weighted quadratic kappa of 0.89 established test-retest reliability. The smallest detectable change at the individual level was 2.66 and at the group level was 0.30. Renzi ODS score and the total (-0.32) and physical (-0.43) SF-36 scores correlated negatively. Patient and control's groups significantly differed (11 points). The change score of Renzi ODS score between baseline and 3 months correlated negatively with the clinical evolution (-0.86). ROC analysis showed minimal important change of 2.00 with AUC 0.97. Neither floor nor ceiling effects were observed. Conclusion -This work validated the Portuguese version of Renzi ODS score. We can now use this reliable, responsive, and interpretable (at the group level) tool to evaluate Portuguese ODS patients.

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“…Symptombased measures included a series of validated questionnaires commonly used to assess obstructed defecation and pelvic floor dysfunction: the short form of the Pelvic Floor Distress Inventory (PFDI), the Obstructed Defecation Syndrome (ODS) questionnaire, and the Bristol Stool Scale [5][6][7]. A subscale of the PFDI was calculated using questions 4, 7, and 8 referring to splinting, straining, and incomplete emptying, respectively.…”

Section: Methodsmentioning

confidence: 99%

Measuring the impact of a posterior compartment procedure on symptoms of obstructed defecation and posterior vaginal compartment anatomy

Grimes

Overholser

et al. 2016

Int Urogynecol J

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Introduction and hypothesis We hypothesized that there would be a significant difference in changes in obstructed defecation symptoms and posterior compartment prolapse between women who underwent posterior vaginal wall prolapse repair (PR) and those who did not. Methods This was a two-site prospective cohort study of women undergoing prolapse or incontinence surgery in which a PR was, or was not, performed at the discretion of the surgeon. Women were assessed using validated obstructed defecation questionnaires and standardized examination measures (including POP-Q, measurement of transverse gh, and assessment for a rectovaginal pocket and laxity) prior to pelvic surgery and 12 weeks after surgery. Results Of 68 women who underwent surgery, 43 had PR. The PR group had higher obstructed defecation symptoms and greater posterior compartment prolapse at baseline. At 12 weeks, obstructed defecation symptoms had improved significantly more in the PR group than in the no PR group (all p < 0.03). Anatomic outcomes showed greater improvement in point Bp in the PR group (−3.4 vs. −0.7 no PR, p < 0.001) and resolution of the rectovaginal pocket (86 % vs. 42 %, p = 0.002). There were no significant changes in obstructed defecation symptoms or anatomic outcomes from baseline in the no PR group, while the PR group showed significantly improved obstructed defecation symptoms and anatomic outcomes after repair (p < 0.001 for both). Conclusions Significant improvements in obstructed defecation symptoms and posterior compartment prolapse were seen after PR, but not in women who did not receive PR. Obstructed defecation symptoms, Bp and rectovaginal pocket were the measures best able to demonstrate improvement after PR. We recommend the use of these measures to assess the impact of surgery in the posterior compartment.

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Set‐up and statistical validation of a new scoring system for obstructed defaecation syndrome

Abstract: The ODS score offers a validated severity of disease index in grading the severity of disease and monitoring the efficacy of therapy.

Cited by 243 publications

References 14 publications

Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

Renzi Score for Obstructed Defecation Syndrome - Validation of the Portuguese Version According to the Cosmin Checklist

Measuring the impact of a posterior compartment procedure on symptoms of obstructed defecation and posterior vaginal compartment anatomy

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