Gracilis muscle transposition with electrical stimulation for sphincteric incontinence: a new approach.
Neurovascularly intact gracilis-muscle transposition to the proximal urethra is an exciting new technique for sphincteric incontinence. The functional urethral closure of gracilis myoplasty assures dryness, permits intermittent self-catheterization when necessary, and avoids the risks of erosion associated with the artificial urinary sphincter. Electrical stimulation of the transposed muscle (dynamic urethral myoplasty) using intramuscular electrodes and a subcutaneously placed pulse generator can alter the molecular physiology of the gracilis muscle from that of predominantly fast-twitch to that of slow-twitch fibers that are fatigue-resistant and more suitable for long-term sphincter function.
Chancellor
M B
MB
Neuro-Urology and Urinary Incontinence Programs, University of Pittsburgh School of Medicine, Pennsylvania, USA.
Heesakkers
J P
JP
Janknegt
R A
RA
D000818:Animals; D004599:Electric Stimulation Therapy; D005260:Female; D006041:Goats; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery; D011468:Prostatectomy; D011817:Rabbits; D051381:Rats; D013524:Surgical Flaps; D014521:Urethra / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery*