Reconstruction of rectal sphincter by transposition of gluteus muscle for fetal incontinence.

Many remedial operations have been described for fecal incontinence. We describe a bilateral gluteus muscle transposition to encircle the rectum with striated muscle. This procedure positions a voluntary muscle around the rectum to produce volitional rectal closure, the opposite direction pulling produces a kinking closure of the rectum, and the newly accentuated anorectal angle also facilitates continence. In 6 incontinent patients, 3 were normalized by this procedure, 1 was improved, and 2 had delayed improvement secondary to the development of a fecaloma. Gluteus muscle transposition may be a useful secondary procedure in that patient with muscle dysfunction deficiency fecal incontinence.