Gracilis-muscle transplant for the correction of anal incontinence: Report of a Case

Abstract

Summary A case of neurogenic anal incontinence successfully corrected by the use of a gracilis-muscle sling has been presented. This procedure was first described by Pickrell and associates6 in 1952. Children born with neurogenically denervated, anal sphincter mechanisms with resulting complete anal incontinence should not be allowed to become social outcasts and should not be condemned to a life in which they are unable to function among their peers. There is no justification for subjecting a child with neurogenic anal incontinence to the difficulties attendant on permanent abdominal colostomy before attempting a method of correction frequently capable of complete rehabilitation. The gracilis-muscle transplant is a procedure whereby the child can regain voluntary anal continence and voluntary control of feces. In this way, these children can again function in society among their peers and live, socially well-adjusted lives. The paper has included an extensive review of the anatomy of the gracilis muscle, as well as a description of the actual procedure of using gracilis muscle to construct a sling to replace the anal sphincter for correction of neurogenic anal incontinence.