Electrically stimulated gracilis sphincter (dynamic graciloplasty) for treatment of intrinsic sphincter deficiency: a pilot study on feasibility and side effects.

Abstract

The feasibility and side effects of electrically stimulated gracilis sphincter (dynamic graciloplasty) were studied in 7 patients with severe incontinence due to intrinsic sphincter deficiency. The distal part of the gracilis muscle is wrapped around the bladder neck. Afterwards, 2 muscle electrodes and a programmable pulse stimulator are implanted. During a stimulation program the fatigable type 2 skeletal fibers are replaced by slow type 1 fibers, which are able to sustain a long lasting contraction. Among the patients 3 are continent, 1 is partially continent and treatment failed in 3. The results are encouraging. Dynamic graciloplasty may have a role in the treatment of intrinsic sphincter deficiency.