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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   charnice burk 
 September 4, 2026
 
 
 Trustindex verifies that the original source of the review is Google. Dr. Nosti is great! I felt very confident in his work. He has done 2 procedures for me and both have gone so smooth. He tells you what to expect and has a plan for those things. I would refer him to anyone having gynecological issues that they need surgery for. Thanks Dr. Nosti!!
  
 
      
   Deb Hundley 
 August 26, 2026
 
 
 Trustindex verifies that the original source of the review is Google. As a Provider in the region I self referred to Dr. Nosti for female pelvic organ prolapse and stress incontinence. From the time I walked in the door for my initial consult to my post-op surgical follow up the process has been seamless. Any hiccups were anticipated and a plan was in place prior. I’ve been nothing but happy with this process and my results.
  
 
      
   Kathryn Gonzalez 
 August 26, 2026
 
 
 Trustindex verifies that the original source of the review is Google. Everyone is so professional and Dr. Nosti is incredible.  Surgery went well.  I feel more confident.
  
 
      
   Rose Hamilton 
 August 25, 2026
 
 
 Trustindex verifies that the original source of the review is Google. This place was amazing, I was treated kindly and softly, everything explained to me as we went, my options and things to help till my next appointment. The office itself is soft, clean, and quiet to help you feel more relaxed in an uncomfortable situation. Everyone was very friendly and respectful. I highly recommend this office. Dr Stork was very friendly, took her time, explained everything and presented my options, pros and cons for each and let me make the choice. She was light-hearted and helped me feel at ease.
  
 
      
   Elaine Smith 
 August 16, 2026
 
 
 Trustindex verifies that the original source of the review is Google. Dr Nosti is wonderful, I would recommend him to any of my friends.  His office staff are kind, courteous and professional.  Highly recommend if you need urogynecology services!!
  
 
      
   Ashlee White 
 August 13, 2026
 
 
 Trustindex verifies that the original source of the review is Google. I have dealt with IC and bladder pain for the last 3 years. Went to a urologist for years and tried anything he threw at me but after years of suffering and plenty of my own research (spiraling), I found Latasha online. She is the first provider that made me feel seen and heard and actually helped me feel better. Thank you, Latasha! ❤️
  
 
      
   Colleen Dublin 
 August 11, 2026
 
 
 Trustindex verifies that the original source of the review is Google. Dr. Nosti and LaTasha are excellent practitioners. They are a busy practice but always have time to make you feel like you're the only patient. (I wouldn't recommend a practice that isn't busy... if it's not, the practitioners aren't any good). The staff is excellent, too. I'm a bit of an expert when judging urologists... I'm in my 50's and was born with a bladder condition. Needless to say, I've seen many urologists since childhood (I move around a lot).
  
 
      
   Jennifer Sada 
 August 2, 2026
 
 
 Trustindex verifies that the original source of the review is Google. This office is extremely clean and well organized. I never had to wait more than two minutes and the staff is very friendly and professional. I felt fully supported by Kellie James and Dr. Nosti at every step of the diagnosis and treatment.
  
 
      
   Lisa Kurz 
 July 20, 2026
 
 
 Trustindex verifies that the original source of the review is Google. I had the best experience with Dr. Nosti, he’s so caring and made me feel very comfortable. I’ve never felt better and my life is back to normal again! He is so wonderful and explained everything. I’m so happy I didn’t wait and his staff at his office and at the hospital were amazing!!
  
 
      
   Lynette Beebe 
 July 20, 2026
 
 
 Trustindex verifies that the original source of the review is Google. I was struggling. Latasha Reed and Dr. Nosti were so helpful.  I can go places without accidents.