Fecal incontinence: can a urologist help?

What causes bowel leakage?

Common causes include childbirth injury to the anal muscle or its nerves, a pelvic floor weakened with age or menopause, loose stool, constipation with liquid stool seeping around it, nerve damage from diabetes or a spinal problem, and surgery or radiation in the pelvis. Knowing the cause tells us which treatment to start with.

When is bowel leakage an emergency?

Go to an emergency department for new leakage with numbness in the groin or inner thighs, new leg weakness or trouble passing urine, especially with back pain. Black, tarry stool or heavy rectal bleeding also needs emergency care. Fever or a sudden change in bowel habits calls for a prompt visit.

What happens at the first visit?

We ask when leaks happen, what your stool is like and which medicines you take, then examine the pelvic floor and check how well the anal muscle squeezes. If you leak urine as well, a urine test and bladder scan are added. Bring a bowel diary if you can.

What is InterStim, and when is it used for bowel leakage?

InterStim is a Medtronic sacral nerve stimulation system for chronic bowel leakage that diet changes, bowel retraining, pelvic floor work and medicine have not controlled. It starts with a short test phase using a temporary wire, and it can be turned off or removed. Our InterStim for bowel control page explains the steps.