[Staged diagnosis of anorectal incontinence]

The complex function of the anal sphincter is established by different functional compartments. Additionally a wide range of incontinence therapies-surgical and conservative-are possible. Therefore a differentiated diagnostic procedure is necessary to indicate the optimal, individual therapy: symptom-orientated step-by-step incontinence diagnostic program. This starts with a basic coloproctological evaluation using patient's history, continence scores, inspection, palpation, proctoscopy and rectoscopy. Functional and morphological evaluation is done by anorectal manometry, endosonography and neurologic procedures. Only in special cases the following procedures are necessary in addition: defecography, transit-time studies, magnetic resonance imaging, colonoscopy, gynecological and urological diagnostics.