Urinary and fecal incontinence are pelvic disorders that result in involuntary loss of control of a bodily function, including normal voiding reflex for urine or the control of a normal bowel movement. These are disabling conditions that are very common especially in older people. People often don't talk to their doctor about it because they are embarrassed, but it’s important to remember that the sooner you talk about it, the sooner you can fix the problem, and keep it from getting worse.
There are two types of urinary incontinence, and frequently people have a combination of both. Consulting a urologist or urogynecologist will be appropriate to determine your unique condition.
- Stress incontinence is caused by activities (coughing, sneezing, laughing, running, or lifting) that affect the bladder due to increased abdominal pressure. When this happens and the pelvic floor muscles aren’t capable of resisting the pressure, leakage can occur.
- Urge incontinence is marked by a need to urinate frequently, even when the bladder isn’t very full. People with this type of urinary incontinence will often describe difficulty making it to the bathroom in time, or often having to interrupt daily activities. There are many causes of urge incontinence, including medical conditions (benign prostatic hyperplasia, Parkinson's disease, multiple sclerosis, stroke, and spinal cord injuries), surgeries (including hysterectomy or prostatectomy), and infections. However, sometimes it’s just a matter of eliminating bladder irritants and using a few simple re-training strategies under the guidance of a specialized physical therapist.
Fecal incontinence is the involuntary loss of stool and/or air through the rectum, including “smearing” which is just a small amount of feces on the underclothing due to incomplete evacuation of bowels. This can occur for a number of reasons including changes to medication, decreased activity, or dietary factors. Pelvic floor musculature can be dysfunctional, contributing to inability to hold stool, but it’s important for the stool consistency to be optimal (ideally soft and formed, like a ripe banana). It’s also important that bowel movements are regular and consistent, reflecting the body’s ability to properly absorb nutrients and fluid. Consulting a gastrointestinal specialist, colorectal specialist and/or a nutritionist may be necessary.
Causes of Urinary and Fecal Incontinence
Causes for urinary and fecal incontinence can be diagnosed in an office setting. An evaluation by your medical provider will include a physical exam to rule out potential serious medical conditions. Testing could involve tests such as urodynamic assessment, cystoscopy, or anal manometry to pinpoint the cause of incontinence. Once we have completed the tests, we can offer you a variety of treatment options.
Treatment for Urinary and Fecal Incontinence
There are very effective treatments available for urinary and fecal incontinence that include medical, therapeutic, and surgical options. The most important thing to remember is incontinence is not a normal part of aging. Talk to your doctor – help is available for this very common condition.