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Related Experiment Videos

Combined urinary and faecal incontinence.

Dharmesh S Kapoor1, Ranee Thakar, Abdul H Sultan

  • 1Clinical Fellow in Urogynecology, Mayday University Hospital, Croydon, UK.

International Urogynecology Journal and Pelvic Floor Dysfunction
|February 25, 2005
PubMed
Summary

Double incontinence, the severe loss of bladder and bowel control, affects 9-19% of the community. Treatment involves surgical repair, nerve stimulation, or artificial sphincters.

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Area of Science:

  • Urology
  • Gastroenterology
  • Gynecology
  • Neurology

Background:

  • Double incontinence, encompassing both urinary and fecal incontinence, represents a severe form of pelvic floor dysfunction.
  • Community prevalence rates are significant, with urinary incontinence affecting 9-19% and fecal incontinence 5-10%, both increasing with age.
  • Contributing factors include childbirth injuries, nerve damage, pelvic organ prolapse, menopause, and neurological conditions.

Purpose of the Study:

  • To review the pathophysiology and treatment of double incontinence.
  • To highlight the link between urinary and fecal urgency due to crossed reflexes.
  • To discuss current and emerging therapeutic options.

Main Methods:

  • Literature review of studies on pelvic floor dysfunction and incontinence.
  • Analysis of etiological factors contributing to combined incontinence.
  • Overview of surgical and non-surgical treatment modalities.

Main Results:

  • Childbirth-associated sphincter injury and pudendal nerve damage are key factors.
  • Pelvic floor descent, menopause, and neurological conditions also contribute.
  • Animal studies suggest crossed reflexes explain the comorbidity of urgency.

Conclusions:

  • Effective management requires etiology-specific treatment, often combining surgical techniques.
  • Options include colposuspension, suburethral slings, sphincteroplasty, sacral nerve neuromodulation, bulking agents, and artificial sphincters.
  • Addressing pelvic floor dysfunction is crucial for improving quality of life.

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