[Functional reconstruction of the striated sphincter muscle in the incontinent anus (author's transl)].

Anal sphincter reconstruction with muscle transplantation according to Thompson and transposition of the denervated gracilis muscle onto the surface of the pelvic floor muscles are described. The transplanted and transposed muscles are reinnervated by a collateral nerve from the adjacent functioning muscles. The follow-up examination of 16 cases of anal incontinence two years after anal sphincter reconstruction demonstrates in all but one case ontinence for firm feces and in most of them, continence for fluid feces. Reflectoric contractions of the new reconstructed sphincter can be demonstrated by myographic and manometric investigations. The advantages of dynamic sphincter reconstruction with muscular neurotization compared to other more static techniques are discussed.