Canine model for treatment of faecal incontinence using transposed and electrically stimulated sartorius muscle.
A neosphincter was successfully created around each end of a Thiry-Vella loop in five dogs using transposed sartorius muscle to study new treatments for faecal incontinence. One of these dynamic neosphincters in each dog was electrically trained for 8 weeks while the other served as a control. Muscle biopsies demonstrated an increase in type 1 fatigue-resistant fibres from a median of 49 (range 37-54) per cent before electrical stimulation to 78 (range 53-99) per cent 8 weeks later in the stimulated sartorius neosphincters (P < 0.05), whereas the percentage of type 1 fibres in control neosphincters increased only slightly. Retention times of saline increased from a median of 10 (range 5-50)s before to 340 (range 100-470)s after electrical stimulation (P < 0.05) but also increased in control neosphincters (to 370 (range 330-1200)s); this may indicate that electrical stimulation immediately increases acute retention times. It is concluded that construction of a neosphincter is technically feasible with preservation of muscle morphology and that stimulation induces morphological and functional changes towards the characteristics of the external anal sphincter.
Konsten
J
J
Department of Surgery, Maastricht University Hospital, The Netherlands.
Baeten
C G
CG
Havenith
M G
MG
Soeters
P B
PB
D001003:Anal Canal / Q000503:physiopathology / Q000601:surgery; D000818:Animals; D004285:Dogs; D004558:Electric Stimulation; D005242:Fecal Incontinence / Q000601:surgery*; D009119:Muscle Contraction; D009132:Muscles / Q000473:pathology / Q000601:surgery*; D011312:Pressure