A 67-year-old woman has daily episodes of solid stool incontinence. Workup includes endoanal ultrasonography, which shows a 70-degree sphincteric defect, and anorectal manometry, which demonstrates low squeeze and resting pressures. Pudendal nerve terminal latency is 2.5 ms bilaterally. She has tried pelvic floor biofeedback without improvement. What is the best next step in treatment?

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