Free autogenous muscle transplantation in the treatment of urinary incontinence in children: background, surgical technique and preliminary results.
Urinary incontinence owing to epispadias or bladder exstrophy is a difficult therapeutic problem. To improve the results a new method, including free autogenous muscle transplantation, was developed. Before transplantation a skeletal muscle (extensor brevis of the foot) is denervated and, 2 weeks later, it is transplanted and placed as a U-sling around the urethra in close contact with normally innervated muscles, which act as reinnervation sources. Two patients showed improvement of continence and increasing bladder capacity from 6 weeks after transplantation. Postoperative cine-studies of micturition demonstrated clearly the functional properties of the transplanted muscle.
D001746:Bladder Exstrophy / Q000150:complications; D002648:Child; D002675:Child, Preschool; D003714:Denervation; D004842:Epispadias / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D009132:Muscles / Q000294:innervation / Q000637:transplantation*; D014034:Toes / Q000601:surgery; D014182:Transplantation, Autologous; D014521:Urethra / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery*