Neuromodulation for Accidental Bowel Leakage

The overarching goal of this randomized clinical trial is to determine if PTNS is more effective than sham PTNS for the treatment of FI in women after 12 weeks of treatment and 1 year after initiating treatment. This is a two-part trial with a Run-In Phase prior to randomization. The trial has the following primary aim: To determine whether the change from baseline in St. Mark's (Vaizey) score in women with symptomatic ABL undergoing PTNS differs from sham after 12 weeks of stimulation. Additional secondary aims include: 1. To compare changes from baseline in self-reported functional outcomes after 12 weekly stimulation sessions in both PTNS and sham groups in Part 1. 2. To determine whether symptom relief amongst study "responders" can be sustained for one year with maintenance treatments in Part II. 3. To determine the impact of completing a bowel diary and receiving education on FI on symptom severity. 4. To determine the ability of the PFDN ABL phone app bowel diary to detect changes from baseline in fecal incontinence episodes recorded to after 12 weeks of stimulation sessions. 5. To determine the association between St. Mark's score and both fat and fiber intake alone and in combination.