[Diagnostics and conservative treatment of anal incontinence]

Wien Med Wochenschr. 2004;154(3-4):76-83. doi: 10.1007/s10354-004-0044-5.
[Article in German]


Anal incontinence is diagnosed primarily by clinical and proctologic examination. Etiological factors of the disease are found in 85% of the patients by additional examinations. Motility dysfunction of colon and rectum has to be excluded (stenosis, dyschezia, internal hernias). Because anal incontinence is a multifactorial disease as a rule, the single compounds have to be diagnosed and have to undergo therapy. Accordingly, useful investigations are: endorectal ultrasound (defect of muscle, inflammatory or tumour infiltration), manometry (alteration of either anal resting pressure and/or anal squeezing pressure) and surface electromyography (ability of contraction, duration of contraction, strength). Neurophysiological examinations are: needle electromyography, pudendal nerve latency time measurement (PNLT). The occurrence of nerve damage determines the outcome of operative intervention! Conservative treatment is indicated in 80 to 90% of all patients, even higher when one includes all patients in the perioperative period. Possible therapy modalities are: nutrition consultation, physiotherapy, pelvic floor training, biofeedback training of pelvic floor and sphincter muscles, electrostimulation and the combination of both (EMG-triggered electrostimulation). Short-term results are satisfying in up to 85% of patients, but later, successful results depend on the patient's willingness or ability to continue training, and on his/her age.

Publication types

  • Comparative Study

MeSH terms

  • Anal Canal / innervation
  • Biofeedback, Psychology
  • Diagnosis, Differential
  • Electric Stimulation Therapy
  • Electromyography
  • Endosonography
  • Fecal Incontinence / diagnosis
  • Fecal Incontinence / etiology
  • Fecal Incontinence / rehabilitation*
  • Humans
  • Manometry
  • Outcome and Process Assessment, Health Care
  • Physical Therapy Modalities
  • Reaction Time / physiology
  • Synaptic Transmission / physiology