Mansoura Numeroalphabetic Constipation Score in Obstructed Defecation Syndrome (ODS): Validation of a New Score

Background and Aim: Many scores were designed to evaluate the severity of constipation especially in obstructed defecation syndrome. This study aims to validate a new scoring system for constipation by comparing it with the existing commonly used scores. Patients and Methods: The data of 96 patients (49 males) complaining of ODS who were admitted to colorectal surgery unit from June 2013 to June 2015 were analyzed. 40 asymptomatic subjects were assigned in the control group. All patients had been assessed by history taking, submitting to three different constipation scoring systems (Wexner, Knowles-Eccersley-Scott-Symptom (KESS) and Mansoura scoring systems). Results: Patients with obstructed defecation were allocated into three subgroups (18 patients with anismus, 37 patients with rectocele, and 41 patients with rectal intussusception) with 40 asymptomatic controls. Mean total Mansoura score in constipated patients was 9.94 (range, 4-12) compared with a mean of 0.95 in control group (range, 0-2). The resulted scoring of Mansoura Score was compared with that of Wexner and KESS scores in both patients and control groups and Mansoura score proved to have a statistically significant relation with the other two scores (p < 0.05). The mean score of the three scoring systems were highly correlated, (Pearson r =0.90). Correlation coefficients were (0.9977, 0.9983) respectively with p value < 0.00001. Conclusion: The Mansoura Numeroalphabetic Constipation Score (MNCS) is a simple, modified version of Wexner and KESS scores. It has the advantage of accurate, rapid and easy assessment of obstructed defecation, differentiating the constipated patient from the normal subject effectively.