COVID-19: Vaccine information and additional resources | Medicaid: The program is changing and you must take steps to keep your UNC Health providers

Anal Sphincter Repair

Count on professionals at North Carolina Surgery (formerly REX Surgical Specialists) to diagnose and treat your anal sphincter if it’s damaged. Take advantage of advanced surgical procedures at our locations in Raleigh and Cary.

What Is an Anal Sphincter?

Your anal sphincter is a ring of muscle that opens and closes at the bottom of your anus and plays a large role in controlling bowel function. When the muscle is damaged or weakened it can cause incontinence—accidental loss of stool.

What Causes Anal Sphincter Damage?

Your anal sphincter can be damaged by a number of causes, including:

  • Childbirth
  • Constipation
  • Nerve damage, impacting your brain’s ability to get signals that your bowels are full
  • Overstraining your bowels
  • Trauma resulting from anal or rectal surgery


To check your sphincter for possible damage, your surgeon may use one of the following tests:

  • Anorectal manometry – Inserts a tiny balloon filled with water into your rectum to test the pressure of anal sphincter muscles
  • Colonoscopy – Takes pictures by using a thin, flexible tube (colonoscope) with an attached camera
  • Digital rectal examination (DRE) – Manually assesses the strength of your anal sphincter muscles
  • Defacography – Uses magnetic waves or X-rays to create high-definition pictures to see how well your pelvic muscles are working during a bowel movement

Treatments for Bowel Incontinence

Partner with a surgeon at North Carolina Surgery to see what’s causing your anal sphincter to stop working correctly and result in incontinence. If your sphincter is damaged and requires surgical repair, your physician will outline your personalized treatment plan that may include complete sphincter repair (sphincteroplasty) or an implantation of a wire that stimulates your bowels (sacral nerve stimulation).

Sphincteroplasty (Sphincter Repair)

Mostly due to traumatic injury, but sometimes due to older, weakened muscles, the ring of muscle outside of your anal canal (external sphincter) may not be able to close tightly enough to keep your stool in. When more conservative treatments do not work, a sphincteroplasty may be an option for you. You’ll receive an enema to clear your bowels. Your surgeon will identify the weakened areas and stitch the damaged ends together to create a complete, tightened ring of muscle. This can help restore your anus to its proper function and shape.

Sacral Nerve Stimulation

Ask about sacral nerve stimulation (sacral neuromodulation) to treat fecal incontinence. This treatment sends mild electronic impulses to your bowel and sphincter muscles. Sacral nerve stimulation occurs in two different stages, which include:

  • Evaluation and testing – To see if sacral nerve stimulation is best for you, a thin temporary wire is inserted near the sacral nerves in your lower back near your tailbone (coccyx), which controls your bladder and bowel. This wire connects to a small external device that delivers stimulation to your nerves. You’ll be evaluated for a couple of weeks to make sure the device works before you start the next phase of treatment.
  • Implantation – After an evaluation, you may receive a permanent device (neurostimulator) that’s implanted just beneath your skin near your tailbone. You’ll benefit from corrected nerve messaging that helps you gain control over your bowels.

Make an Appointment

Call 919-784-4160 to make an appointment with a surgeon or get help finding a provider. Or request an appointment online.

Related Locations