Studies have shown that individuals’ quality of life is affected by bowel symptoms in many ways . In men and women, 52% of people with major incontinence and 16% of people with minor incontinence reported that bowel symptoms had a significant impact on their quality of life (QoL). The St. Mark’s (Vaizey) Incontinence Score (SMIS) is the scale that correlates the most with the clinician's clinical findings about the severity of anal incontinence, compared to other scoring systems, in persons referred for anorectal physiologic evaluation and complaining of anal incontinence [1]. This scale consists of 7 Likert type questions in two parts and stands out with its short application time. While the first part includes questions about the disease status, the second part includes questions about lifestyle changes that may occur due to the disease [2]. The aim of our study is to ensure the Turkish validity and reliability of St.Mark's (Vaizey) Incontinence Score in patients with anal incontinence, and to provide researchers with a chance to collect and compare data in Turkish in a global and intercultural manner with this adaptation.

This is a prospective case-control study.
Sixty five people with the complaint of anal incontinence who over the age of 18 and were diagnosed with anal incontinence in our clinic, included in the study. People who have difficulties in understanding and speaking Turkish were excluded. Five out of sixty five patients were not included in the analysis from the data included in the pre-test group.  
Translation-re-translation method has been used to adapt the scale. While the first interviews were made face-to-face, the second interviews were made face-to-face or by phone/email, after 2 week. The opinions of experts in the field were consulted for content and construct validity.

The Kaiser – Meyer – Olkin coefficient was close to 1 and the Bartlett sphericity test significance level was < 0.05. According to the factor analysis results, the number of factors with an eigenvalue greater than 1 was 2. The first factor explains 52.33% of the total variance, and the second factor explains 17.17%. The Cronbach alpha coefficient calculated to determine the reliability level of the scale used in the study was found to be r: 0.76.

The diagnosis of anal incontinence is extremely difficult, as patients are reluctant to report this embarrassing symptom, treating physicians often do not investigate it, and there is no clear and validated approach to diagnosing it. The recently reported Pelvic Floor Disorders Consortium consensus recommends the usage of SMIS scales in clinical practice [3]. As an output of this study, the SMIS scale can be used in Turkish language and culture.

According to the result of the study, the Turkish St.Mark's (Vaizey) Incontinence Score is a valid and reliable scale to be used in the evaluation and follow up of incontinence.

Roos AM, Sultan AH, Thakar R. St. Mark's incontinence score for assessment of anal incontinence following obstetric anal sphincter injuries (OASIS). Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(4):407-410. doi:10.1007/s00192-008-0784-7
Vaizey CJ, Carapeti E, Cahill JA, Kamm MA. Prospective comparison of faecal incontinence grading systems. Gut. 1999;44(1):77-80. doi:10.1136/gut.44.1.77
Bordeianou LG, Anger JT, Boutros M, et al. Measuring Pelvic Floor Disorder Symptoms Using Patient-Reported Instruments: Proceedings of the Consensus Meeting of the Pelvic Floor Consortium of the American Society of Colon and Rectal Surgeons, the International Continence Society, the American Urogynecologic Society, and the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction. Female Pelvic Med Reconstr Surg. 2020;26(1):1-15. doi:10.1097/SPV.0000000000000817