title: Reconstruction of the Urethral Sphincter with Dynamic Graciloplasty in a Male Rabbit Model.
abstract: BACKGROUND
  The use of artificial urinary sphincters can improve urinary incontinence after radical prostatectomies; however, complications can arise. We hypothesized that dynamic graciloplasty improves urethral sphincter reconstruction.
  
  
  METHODS
  Models of urethral sphincter muscle reconstruction were developed in 5 adult rabbits by wrapping the gracilis muscle flap around the urethra. Intra-urethral pressure was measured in each of the models before reconstruction (control), after reconstruction, and after electrical stimulation of the flap in reconstructed models (stimulated models).
  
  
  RESULTS
  The mean maximum urethral closure pressure was significantly greater in the reconstruction model (69.7 (66.5-115.8) mm Hg) than in the control model (39.2 (33.7-49.6) mm Hg). The mean integral of the urethral pressure and urethral length was also significantly greater in the reconstruction model than in the control model. Furthermore, sphincter tightening was enhanced by the electrical stimulation of the flap.
  
  
  CONCLUSIONS
  Our results support our hypothesis that the functional reconstruction of urethral sphincters using muscle flaps is promising for the treatment of urinary incontinence.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ota Memorial Hospital, Tokyo, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Uchikawa-Tani
authors.forename: Masaki
authors.initials: M
authors.lastname: Yazawa
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sakuma
authors.forename: Makoto
authors.initials: M
authors.lastname: Hikosaka
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Takayama
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kishi
mesh_terms: D000818:Animals; D004558:Electric Stimulation; D000071976:Gracilis Muscle / Q000294:innervation / Q000601:surgery*; D008297:Male; D023421:Models, Animal; D009119:Muscle Contraction; D064827:Myocutaneous Flap / Q000294:innervation; D011312:Pressure; D011817:Rabbits; D019651:Plastic Surgery Procedures; D014521:Urethra / Q000503:physiopathology / Q000601:surgery*; D014549:Urinary Incontinence / Q000503:physiopathology / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male