Electrically stimulated gracilis sphincter for treatment of bladder sphincter incontinence.

Correction of total urinary incontinence due to sphincter damage is done with an artificial sphincter prosthesis or urinary diversion. In this pilot study we used graciloplasty around the bladder neck followed by electrical stimulation of this muscle with an implanted stimulator, which could be switched off and on by a magnet. Stimulus variables could be changed externally. With the stimulator on, urethral pressures of about 50 cm H2O were obtained. Of three patients who underwent the procedure, two became continent and one improved but remained incontinent. Dynamic graciloplasty can restore urinary incontinence.