The cause of urinary or fecal incontinence may be a complex one. A central or peripheral neurogenic lesion is frequently found to be accounting for the problem. The diagnosis should be specified by neurologic examinations and adequate neurophysiologic workup prior to any conservative or surgical treatment. Of particular expressiveness are, neurological history, both neurography of the pudendal nerve and electromyography of the external anal sphincter. Additional measures such as recording of the motor or sensory potentials, determination of reflex latencies and an electromyogram of other striated muscles of the pelvic floor may be taken as needed. Close co-operation of gynecologists, proctologists, and neurophysiologically trained neurologists will help to improve the prospects of treatment and avoid inappropriate therapeutic approaches.