Validation of the Baylor Continence Scale in children with anorectal malformations

Background: Anorectal malformations (ARMs) often result in lifelong problems with defecation. There have been no studies performed to develop scoring systems in children with fecal incontinence following repair of ARM. This study was designed to develop and validate a tool (Baylor Continence Scale [BCS]) to measure social continence in children after surgical correction of ARMs. Methods: The BCS is a 23-question survey, was administered to children who have had repair of an ARM, children with enuresis, and normal children. Results: Children in the ARM group had an average BCS score of 28.0, which was statistically different from an enuresis control group (16.5) and normal controls (11.5) (P < .05). A significantly greater proportion of children in the ARM group had higher Impact on Family Scores (>30) than either the enuresis or normal control group (P < .05). Conclusions: The BCS tool should be useful in prospective studies of interventions to improve incontinence after repair of an ARM. An important secondary result of this study was to demonstrate the effect on families of caring for a child with imperforate anus, even years after the repair.