Causes and Diagnoses

Causes and Diagnoses of Incontinence

Both urinary and fecal incontinence can be caused by damage to the nerves that signal the muscles that control the elimination of urine and fecal matter. That damage may be due to:

  • Urinary tract infection
  • Bladder stones
  • Surgery
  • Injury
  • Medication
  • Diabetes
  • Kidney disease
  • Neurological disorder
  • Movement disorder
  • Tumor or other obstruction

Other causes in women include:

  • Pregnancy
  • Childbirth
  • Menopause / decrease in estrogen
  • Gynecologic surgery, such as hysterectomy

In men, causes may also include:

  • Prostate cancer
  • Enlarged prostate

Diagnoses  

If you experience incontinence or overactive bladder on a regular basis, it is important to get a complete physical examination of the urinary and nervous systems, reproductive organs and urine samples. Further testing might include: 

  • Anorectal manometry: Used to study the function of the anus and rectum, this test evaluates of the strength of the muscles that control bowel movements. 
  • Complex uroflowmetry: This procedure measures the amount of urine in the bladder and the rate at which the urine flows. 
  • Cystometry: Also called a cystometrogram, this procedure is administered to measure pressure in the bladder. The test requires patients to perform certain maneuvers while their bladder is being filled gently with sterile water through a catheter. 
  • Electromyography (EMG) testing: EMG testing determines if the nerves supporting the sphincter muscles are intact and that the muscles relax and contract as they should. 
  • Pelvic ultrasound: This imaging test uses high-frequency sound waves to create an image of the organs. 
  • Post-void residual study: This determines how much urine remains in the bladder after urination.  
  • Pressure-flow voiding study: This test determines the ability of the bladder and urethra to properly expel urine. 
  • Pudendal nerve latency testing: This testing is used to determine malfunctions of the nerve that stimulates the sphincter muscle related to stool continence. 
  • Transrectal and transanal 3D ultrasound: These ultrasounds show images of the low rectum, anal sphincters and pelvic floor in patients with a variety of anorectal disorders. 
  • Urethral pressure profilometry: This procedure reveals the pressure in the urethra. The results can help doctors guide surgical treatment. 
  • Urinalysis: Your urine will be checked for the presence of infection or blood.  
  • Video urodynamic testing: This allows doctors to visualize the size and shape of your urinary tract. It is commonly used when you have experienced urine leakage or blocked flow of urine.