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Combined urinary and faecal incontinence

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Abstract

Combined urinary and faecal (liquid or solid) incontinence (double incontinence) is the most severe and debilitating manifestation of pelvic floor dysfunction. The community prevalence is 9–19% (urinary) and 5–10% (faecal), increasing with age. Pathophysiological factors include childbirth-associated external anal sphincter injury and pudendal nerve damage, pelvic floor descent, menopause, collagen disorders and multiple sclerosis-like conditions. The presence of crossed reflexes between the bladder, urethra, anorectum and pelvic floor in animal studies may explain the comorbidity of urinary and faecal urgency. Surgical treatment is based on aetiology and combined optimum techniques such as colposuspension or suburethral sling with overlapping sphincteroplasty. Other methods for improving sphincteric control include sacral nerve neuromodulation, bulking agents and artificial sphincters.

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  1. Clinical Fellow in Urogynecology, Mayday University Hospital, 530 London Road, Croydon, CR7 7YE, UK

    Dharmesh S. Kapoor

  2. Consultant Urogynecologist, Mayday University Hospital, 530 London Road, Croydon, CR7 7YE, UK

    Ranee Thakar

  3. Consultant Obstetrician and Gynecologist, Mayday University Hospital, 530 London Road, Croydon, CR7 7YE, UK

    Abdul H. Sultan

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  1. Dharmesh S. Kapoor
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Correspondence to Abdul H. Sultan.

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Kapoor, D.S., Thakar, R. & Sultan, A.H. Combined urinary and faecal incontinence. Int Urogynecol J 16, 321–328 (2005). https://doi.org/10.1007/s00192-004-1283-0

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