Ryan Stewart, DO
Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed May 14, 2026

Does Sacral Neuromodulation Help with Bowel Control?

Yes — sacral neuromodulation (SNM) is FDA-approved for fecal incontinence. Think of it as a bowel pacemaker: a small device placed under the skin that sends gentle electrical signals to the nerves controlling bowel function. The same device used for overactive bladder also works for bowel control, which makes it a good option for women dealing with both bladder and bowel leakage.

How it helps

The device works on the sacral nerves, which control the muscles and sensation of the rectum, anal sphincter, and pelvic floor. By calming and regulating those nerve signals, it can:

• Reduce or eliminate episodes of accidental bowel leakage
• Improve the ability to sense when the rectum is full
• Improve anal sphincter function
• Reduce urgency and the need to rush to the bathroom

What makes SNM different from other treatments is that it works through the nerves, not the muscles. Even when the anal sphincter is torn or weakened, improving nerve signaling can restore functional control. This also means that having a sphincter defect is not a barrier to getting SNM — it has largely replaced sphincter repair surgery, which had poor long-term durability and a difficult recovery.

The trial period

Just like with bladder applications, SNM for fecal incontinence includes a trial period. A temporary wire is placed and tested for about two to three weeks (bowel trials run a bit longer than bladder trials). If you experience at least 50% improvement in episodes, the permanent device is implanted. Rechargeable devices last 15 or more years before needing replacement.

Results from clinical trials

• About 90% of patients who do well in the trial go on to get the permanent implant
• In pivotal trials, patients went from an average of about 9 episodes per week down to 2
• At 12 months, 83% maintained meaningful improvement; at 5 years, 89% still had therapeutic success
• About 40% of patients achieve complete continence

For women dealing with both bladder and bowel leakage, the fact that one device can treat both is a real advantage. I find myself recommending it more and more for exactly that reason.

References

1. Meyer I, Richter HE. Evidence-based update on treatments of fecal incontinence in women. Obstet Gynecol Clin North Am. 2021. doi:10.1016/j.ogc.2021.05.009
2. Brown HW, et al. Fecal incontinence. In: Walters & Karram Urogynecology and Reconstructive Pelvic Surgery. 5th ed. 2020.
3. Meyer I, Richter HE. Impact of fecal incontinence and its treatment on quality of life in women. Womens Health. 2015. doi:10.2217/whe.14.66
4. Goldman HB, et al. International Continence Society best practice statement for use of sacral neuromodulation. Neurourol Urodyn. 2018. doi:10.1002/nau.23515

← Learn more about Fecal Incontinence

---

Frequently Asked Questions

Can one device treat both bladder and bowel problems?

Yes. Sacral neuromodulation is FDA-approved for both overactive bladder/urge incontinence and fecal incontinence. One device can address both conditions simultaneously.

What if the trial doesn't work?

If the trial period doesn't show sufficient improvement, the temporary wire is simply removed. No permanent changes have been made, and other treatment options remain available.

Is the surgery for bowel SNM different from bladder SNM?

No. The procedure is identical — the same device, same nerve target, same trial process. The sacral nerves control both bladder and bowel function.