**2.1 Idiopathic anorectal incontinence**

Neurogenic anorectal incontinence is considered idiopathic, especially in women, because it may be due to damage of the nerves innervating the pelvic floor muscles. Causes of idiopathic anorectal incontinence are usually associated with difficult childbirth, constipation with chronic straining at stool, rectal prolapse, descending perineum syndrome, and advanced age. Pathophysiology of idiopathic anorectal incontinence is attributed to traction of the pudendal nerve or compression of the sacral nerves by the pelvic floor that descends or to pressure by the fetal head. Evidence that idiopathic incontinence relates to denervation injury of the pelvic floor seems clearly in manometry, electromyography, and pudendal nerve latency studies. These studies show that idiopathic incontinence is characterized by weakness of the pelvic floor and anal canal musculature [16].
