GRACILIS MUSCLE TRANSPOSITION WITH ELECTRICAL-STIMULATION FOR SPHINCTERIC INCONTINENCE - A NEW APPROACH

Neurovascularly intact gracilis-muscle transposition to the proximal u rethra is an exciting new technique for sphincteric incontinence. The functional urethral closure of gracilis myoplasty assures dryness, per mits intermittent self-catheterization when necessary, and avoids the risks of erosion associated with the artificial urinary sphincter. Ele ctrical stimulation of the transposed muscle (dynamic urethral myoplas ty) using intramuscular electrodes and a subcutaneously placed pulse g enerator can alter the molecular physiology of the gracilis muscle fro m that of predominantly fast-twitch to that of slow-twitch fibers that are fatigue-resistant and more suitable for long-term sphincter funct ion.