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I have suffered anal sphincter tear which was not repaired 24 yrs ago. I suffer with bowel incontinence which has had a great impact on my quality of life. Sacral Nerve Stimulation is not an option as I am thin and have tried PTNS. Any advice from experts would be appreciated. Thanks

First thing to do would be to ensure you have made appropriate dietary changes to relieve either constipation or diarrhoea which could be exacerbating your symptoms. Appropriate exercises to increase the strength of the relevant muscles plus or minus some medical therapy may help. You may have already exhausted these avenues and been assessed- hence requiring PTNS. This can take a while plus the appropriate adjustments to work most effectively. Anorectal physiology studies can sometimes be used to assess the severity and nature of the problem, and biofeedback has also been shown to be helpful for faecal incontinence.