Surgical Management

Many women find relief through diet changes and medicines. Sometimes women may need surgery to obtain relief from accidental bowel leakage, such as to repair a torn anal sphincter muscle.

Percutaneous tibial nerve stimulation (PTNS)

Outpatient office procedure in which a slim needle electrode is temporarily inserted near your ankle and connected to a battery-powered stimulator. This is like a combination of acupuncture and a TENS unit. The impulses travel through the tibial nerve and then to the sacral nerve plexus. Each treatment lasts for approximately 30 minutes weekly for usually up to 12 weeks. This has been shown to decrease fecal incontinence in the short term. It can also help urinary urgency incontinence. Potential side effects include discomfort and pain near the stimulation site.

Sacral nerve stimulation (SNS)

An implantable system (similar to a heart pacemaker) that sends mild electrical impulses to the sacral nerves. It can be helpful in patients who have failed other options. It typically involves a one- to two-week trial prior to placement of the permanent lead (a thin wire) and stimulator. If the trial period is not successful, the permanent device will not be implanted. Because the device is metal, you would not be able to have MRIs in this area if the device is implanted. Studies found that women who had SNS experienced fewer episodes of fecal incontinence compared to women who were treated with other medical therapies. Some women even regained full control of the bowels. Risks of this procedure include infection and pain/discomfort of the lead or stimulator. Some women require additional surgeries.

Overlapping Anal Sphincteroplasty

Some women have injury to the anal sphincter muscles following vaginal delivery. Repair of torn anal sphincter muscles with surgery is possible for some women. However, for many women this surgery has a low success rate. Therefore, it is not an option for everyone. For example, an overlapping anal sphincteroplasty is more successful when the nerves are working properly.

Injectable Anal Bulking Agents

Bulking agents are injected in and around the anal canal to help hold in stool for people with fecal incontinence. Dextranomer hyaluronic acid (Solesta®), is FDA approved for this problem. It is thought to narrow the anal canal, which helps to improve control of stool by the anal sphincter muscles.

Bulking agents can be effective for women with moderate symptoms. This option does not work for everyone. Studies have found bulking agents to be effective for about half of the women who choose this option. It may take 3 to 6 months before improvements are seen. In addition, some women need more than one injection to see improvements. This treatment may not be covered by your insurance.

The procedure is typically done in an outpatient setting, similar to a colonoscopy. Mild or moderate discomfort or pain in the rectum or anus is common. In addition, you may experience some mild bleeding or spotting in the rectum. Ask your doctor about risks and side effects.

Magnetic Anal Sphincter

An emerging treatment is a flexible ring of magnets that is implanted around the anal canal to increase the strength of the anal sphincter. Straining to defecate when you need to normally will separate the beads to allow voluntary passage of stool. This treatment seems to be effective for some patients in the short term, however studies to determine how well this works over time are still underway.

Rectocele Repair

A rectocele is a prolapse of the rectum upward into the vagina, similar to a hernia. If stool is getting “trapped” in the rectocele pouch, it can seep out later. Repairing the rectocele surgically can sometimes lead to improved bowel emptying.

Hemorrhoid Surgery

Significant hemorrhoids may prevent the anus from making a tight seal and lead to stool leakage. Repair of the hemorrhoids can sometimes help reduce this seepage.

Fistula Repair

If a fistula (abnormal connection between the bowel and vagina) is present, closing the fistula is generally curative when there are no other factors contributing to the anal incontinence.

Rectal Prolapse Repair

If a rectal prolapse is present with a bulge at the anus, there are several surgeries that can be done to repair this. Some of these are done through the abdomen, either with a large incision or with laparoscopic surgery. Other people undergo surgery at the anal opening. Discuss with your colorectal surgeon what is best for you.

Fecal Diversion

When other treatment options have failed for severe ABL, one option is to re-route the bowels so that they empty in a bag rather than through the anus. These are called a colostomy or ileostomy depending on which part of the bowel is brought up to the bag.

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   Gwen Morgan 
 November 13, 2026
 
 
 Trustindex verifies that the original source of the review is Google. I’m very grateful to Dr Nosti for the success of my bladder surgery.  I am 8 weeks out and to date this surgery has definitely changed my quality of life.  I sincerely wish I had found him years ago and had this surgery.    Without my other doctors encouraging me I might never have gone to see Dr. Nosti because of the distance of the drive. My physical, emotional, and mental outlook have been altered positively due to this surgery.  His skills have made my life so much better!
  
 
      
   Cathy Zinke 
 November 13, 2026
 
 
 Trustindex verifies that the original source of the review is Google. Dr. Nosti and his staff are the best. My gynecologist recommended his office and I'm grateful she did. They are professional and very caring towards their patients. From the moment I entered his office, that first appointment, trying to figure out the best choice for my particular situation, the surgery, recovery and post-op appointment, and insurance questions that came up, everyone treated me with compassion. I have already told friends that if they need a Urogynecologist they should definitely use Dr. Nosti.
  
 
      
   Maseerah Muradabadi 
 November 12, 2026
 
 
 Trustindex verifies that the original source of the review is Google. The best doctor for post delivery recovery! Excellent diagnosis and treatment! I highly recommend Latasha Reed WHNP! I was diagnosed with BPS / IC for 8 years post my first c section, I saw too many providers in India as well as the US. However, this time when I checked in with Latasha, she was so accurate with my diagnosis and suggested excellent treatment and medication options which helped me get rid of my issues and restored the quality of life that I always wanted !!
  
 
      
   Barb Pink 
 November 12, 2026
 
 
 Trustindex verifies that the original source of the review is Google. I would highly recommend Dr Patrick Nosti MD for any women with urology issues or other female issues I put off my issues way too long & am so happy my gynecologist referred me on to Dr Nosti. He is professional & explains treatment plans fully so you can make choices right for you. Please do not wait for help. Call his office now!
  
 
      
   Kathy Ginestra 
 November 9, 2026
 
 
 Trustindex verifies that the original source of the review is Google. Kind and understanding. Surgery went very well.  Very happy I used Dr Nosti.
  
 
      
   Texanna Ollenberger 
 November 9, 2026
 
 
 Trustindex verifies that the original source of the review is Google. Dr. Nosti,   Please excuse my tardiness in Thanking You for doing my surgery and giving me the opportunity to do a newer surgery that provided me with a quicker recovery time than what I had expected. I have just finished my 12th week following surgery. I feel great and for the past 6 weeks I have been back to my regular work schedule. No longer do I rely on my children or friends to help me. THANK YOU!  Sincerely, Texanna Ollenberger
  
 
      
   Lorraine Ford 
 November 6, 2026
 
 
 Trustindex verifies that the original source of the review is Google. If your looking for a urogynocolist Dr Nosti is your man he's the best. Great beside manners,caring and compassionate. Great staff too.
  
 
      
   Jenny H 
 November 4, 2026
 
 
 Trustindex verifies that the original source of the review is Google. I cannot recommend LaTasha Reed, WHNP, highly enough. From the moment you walk into her care, it is completely evident that she treats her patients as whole people, not just a list of medical symptoms.
No one ever wants to find themselves needing treatment for women’s health issues, but LaTasha approaches her work with a profound sensitivity to exactly that. She pairs deep clinical expertise with genuine compassion, completely removing any anxiety or discomfort from the experience.
Instead of the usual rushed, quick-visit feel of modern medicine, LaTasha takes the time to truly get to know you beyond the chart. She dedicates an impressive amount of time to patient education, ensuring you fully understand your body, your options, and your path forward. If you are looking for a provider who will truly advocate for you, listen to you, and invest in your well-being, LaTasha is the absolute gold standard.
  
 
      
   Kathleen Asbury 
 November 4, 2026
 
 
 Trustindex verifies that the original source of the review is Google. Dr Nosti is a great listener! I am 6 weeks post op and he was reassuring, kind, and a definite expert in telling me what to expect! Everything he has explained has been exactly as I've experienced it. How wonderful for his patients! I would highly recommend Dr. Nosti and everyone in his office for Urogynecology care.
  
 
      
   Veronica Malm 
 October 16, 2026
 
 
 Trustindex verifies that the original source of the review is Google. I am so grateful to have found Dr. Nosti. He is incredibly kind, patient, and always takes the time to answer all of my questions. He is an outstanding professional, and I feel very fortunate to have been under his care.
His entire team, from the clinic staff to the operating room team, was truly wonderful.Everyone was extremely professional, attentive, compassionate, and supportive exactly what you need when going through surgery.
Six weeks after my surgery, I can honestly say that I would rate this entire team a 10/10, both professionally and, just as importantly, on a human level.
Thank you, Dr.Nosti, and thank you to the entire team for taking such great care of me. I couldn’t be more grateful!💕