Comparison of the Efficacy of a Biological Implant to Reinforce Overlapping Sphincter Repair Versus Overlapping Sphincter Repair Alone

Inclusion Criteria: * Female * Age 18 years or older * fecal incontinence due to an anterior defect in the external anal sphincter or both external and internal anal sphincter muscles * Fecal incontinence severity score of 10 or more * Fecal incontinence episodes of 4 or more over a 2 week period Exclusion Criteria: * History of diabetes * History of allergy to porcine derivatives * History of infection in the anal area (abscess, fistula) * History of inflammatory bowel disease * History of hidradenitis suppurativa * History of immunosuppression * History of HIV positivity * History of radiation to the study site within the last 12 months * Patients who cannot travel to keep follow up appointments * Patients who are prisoners * Patients who are mentally handicapped * Patients who are pregnant or plan to become pregnant during the study period, or who are currently breastfeeding * Patients with significant posterior pelvic organ prolapse and who would be candidates for concomitant treatment. * Patients with a FIQL baseline score of ≤ 4 * Patients participating in another clinical trial for the same indication * Patients unwilling to give informed consent