PRELIMINARY-RESULTS OF MUSCLE CUFF CERVICOPLASTY IN THE EWE FOR THE TREATMENT OF URINARY-INCONTINENCE

Objective: Muscle cuff cervicoplasty consists of dissecting a strip of the superior slip of the levator ani muscle, by sectioning it flush w ith the symphysis pubis, and applying it like a cuff around the urethr a below the bladder neck. Methods: We conducted a preliminary study in 12 ewes, including preoperative urodynamic assessment? intravenous ur ography with retrograde cystography on day 15, and another urodynamic assessment 1 and 3 months after the operation. Two animals died, but t he other 10 animals were able to be evaluated. An increase in the uret hral functional length with an infracervical plateau was revealed on a ll postoperative urethral profiles. Only transrectal electrostimulatio n, performed on the last 5 ewes, demonstrated an elevation of the clos ure pressure by 5-10 cm H2O. At sacrifice of the animals at 4 months, in situ stimulation of the muscle strip induced muscle contraction in 7 of 10 cases. Histological examination demonstrated persistence of mu scle fibers in the cuff, despite the presence of marked fibrosis. Resu lts: The preliminary results are encouraging: urinary continence was i mproved with a minimal risk of retention, and cervicoplasty appears to retain its contractile activity, suggesting the possibility of a long -term sphincteric and proprioceptive action. Conclusion: This techniqu e could be proposed in women suffering from urinary stress incontinenc e with sphincter hypoactivity.