Muscular urinary sphincter: electrically stimulated myoplasty for functional sphincter reconstruction

M M Palacio; V C Van Aalst; G A Perez Abadia; R W Stremel; P M Werker; X Ren; G D Petty; S J Heilman; J G Van Savage; A Garcia Fernandez; M Kon; G R Tobin; J H Barker

doi:10.1016/S0022-5347(01)62434-0

Muscular urinary sphincter: electrically stimulated myoplasty for functional sphincter reconstruction

M M Palacio, V C Van Aalst, G A Perez Abadia, R W Stremel, P M Werker, X Ren, G D Petty, S J Heilman, J G Van Savage, A Garcia Fernandez, M Kon, G R Tobin, J H Barker

Research output: Contribution to journal › Article › Academic › peer-review

10 Citations (Scopus)

Abstract

PURPOSE: To reconstruct an electrically stimulated muscular urinary sphincter (MUS) using a tailored gracilis muscle free flap with intact nerve.

MATERIALS AND METHODS: Unilateral surgically tailored gracilis muscle free flaps were transferred into the pelvis in eight dogs, leaving the obturator nerve intact. The muscle's pedicle vessels were anastomosed to the inferior epigastric artery and vein in the pelvis and the muscle was wrapped around the bladder neck. Electrodes were inserted into the MUS and connected to a programmable pulse generator. After 8 weeks of training the MUS, the pulse generator was programmed to be "on" for 4 hours and "off' for 15 minutes in a continuous cycle. Urodynamic studies were performed periodically, and at the end of the experiment the MUS and proximal urethra were harvested for histology. Three control dogs had sham operations.

RESULTS: All MUS's functioned well following the procedure. Histology of the MUS/urethra complex showed no evidence of stricture. Except for one dog, all urethras were easily catheterized.

CONCLUSIONS: This electrically stimulated innervated free-flap MUS technique effectively increases bladder outlet resistance without producing urethral obstruction.

Original language	English
Pages (from-to)	1867-1871
Number of pages	5
Journal	Journal of Urology
Volume	160
Issue number	5
DOIs	https://doi.org/10.1016/S0022-5347(01)62434-0
Publication status	Published - Nov-1998
Externally published	Yes

Keywords

Animals
Dogs
Electric Stimulation
Female
Muscle, Skeletal
Surgical Flaps
Urethra
Urinary Incontinence
Urologic Surgical Procedures
GRACILIS SPHINCTER
INCONTINENCE
EXPERIENCE
CHILDREN
MUSCLE
FLAP

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Muscular urinary sphincter
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Palacio, M. M., Van Aalst, V. C., Perez Abadia, G. A., Stremel, R. W., Werker, P. M., Ren, X., Petty, G. D., Heilman, S. J., Van Savage, J. G., Garcia Fernandez, A., Kon, M., Tobin, G. R., & Barker, J. H. (1998). Muscular urinary sphincter: electrically stimulated myoplasty for functional sphincter reconstruction. Journal of Urology, 160(5), 1867-1871. https://doi.org/10.1016/S0022-5347(01)62434-0

@article{e687f5aa6a344ec5926c5670df66e9e8,

title = "Muscular urinary sphincter: electrically stimulated myoplasty for functional sphincter reconstruction",

abstract = "PURPOSE: To reconstruct an electrically stimulated muscular urinary sphincter (MUS) using a tailored gracilis muscle free flap with intact nerve.MATERIALS AND METHODS: Unilateral surgically tailored gracilis muscle free flaps were transferred into the pelvis in eight dogs, leaving the obturator nerve intact. The muscle's pedicle vessels were anastomosed to the inferior epigastric artery and vein in the pelvis and the muscle was wrapped around the bladder neck. Electrodes were inserted into the MUS and connected to a programmable pulse generator. After 8 weeks of training the MUS, the pulse generator was programmed to be {"}on{"} for 4 hours and {"}off' for 15 minutes in a continuous cycle. Urodynamic studies were performed periodically, and at the end of the experiment the MUS and proximal urethra were harvested for histology. Three control dogs had sham operations.RESULTS: All MUS's functioned well following the procedure. Histology of the MUS/urethra complex showed no evidence of stricture. Except for one dog, all urethras were easily catheterized.CONCLUSIONS: This electrically stimulated innervated free-flap MUS technique effectively increases bladder outlet resistance without producing urethral obstruction.",

keywords = "Animals, Dogs, Electric Stimulation, Female, Muscle, Skeletal, Surgical Flaps, Urethra, Urinary Incontinence, Urologic Surgical Procedures, GRACILIS SPHINCTER, INCONTINENCE, EXPERIENCE, CHILDREN, MUSCLE, FLAP",

author = "Palacio, {M M} and {Van Aalst}, {V C} and {Perez Abadia}, {G A} and Stremel, {R W} and Werker, {P M} and X Ren and Petty, {G D} and Heilman, {S J} and {Van Savage}, {J G} and {Garcia Fernandez}, A and M Kon and Tobin, {G R} and Barker, {J H}",

year = "1998",

month = nov,

doi = "10.1016/S0022-5347(01)62434-0",

language = "English",

volume = "160",

pages = "1867--1871",

journal = "Journal of Urology",

issn = "0022-5347",

publisher = "LIPPINCOTT WILLIAMS & WILKINS",

number = "5",

}

Palacio, MM, Van Aalst, VC, Perez Abadia, GA, Stremel, RW, Werker, PM, Ren, X, Petty, GD, Heilman, SJ, Van Savage, JG, Garcia Fernandez, A, Kon, M, Tobin, GR & Barker, JH 1998, 'Muscular urinary sphincter: electrically stimulated myoplasty for functional sphincter reconstruction', Journal of Urology, vol. 160, no. 5, pp. 1867-1871. https://doi.org/10.1016/S0022-5347(01)62434-0

TY - JOUR

T1 - Muscular urinary sphincter

T2 - electrically stimulated myoplasty for functional sphincter reconstruction

AU - Palacio, M M

AU - Van Aalst, V C

AU - Perez Abadia, G A

AU - Stremel, R W

AU - Werker, P M

AU - Ren, X

AU - Petty, G D

AU - Heilman, S J

AU - Van Savage, J G

AU - Garcia Fernandez, A

AU - Kon, M

AU - Tobin, G R

AU - Barker, J H

PY - 1998/11

Y1 - 1998/11

N2 - PURPOSE: To reconstruct an electrically stimulated muscular urinary sphincter (MUS) using a tailored gracilis muscle free flap with intact nerve.MATERIALS AND METHODS: Unilateral surgically tailored gracilis muscle free flaps were transferred into the pelvis in eight dogs, leaving the obturator nerve intact. The muscle's pedicle vessels were anastomosed to the inferior epigastric artery and vein in the pelvis and the muscle was wrapped around the bladder neck. Electrodes were inserted into the MUS and connected to a programmable pulse generator. After 8 weeks of training the MUS, the pulse generator was programmed to be "on" for 4 hours and "off' for 15 minutes in a continuous cycle. Urodynamic studies were performed periodically, and at the end of the experiment the MUS and proximal urethra were harvested for histology. Three control dogs had sham operations.RESULTS: All MUS's functioned well following the procedure. Histology of the MUS/urethra complex showed no evidence of stricture. Except for one dog, all urethras were easily catheterized.CONCLUSIONS: This electrically stimulated innervated free-flap MUS technique effectively increases bladder outlet resistance without producing urethral obstruction.

AB - PURPOSE: To reconstruct an electrically stimulated muscular urinary sphincter (MUS) using a tailored gracilis muscle free flap with intact nerve.MATERIALS AND METHODS: Unilateral surgically tailored gracilis muscle free flaps were transferred into the pelvis in eight dogs, leaving the obturator nerve intact. The muscle's pedicle vessels were anastomosed to the inferior epigastric artery and vein in the pelvis and the muscle was wrapped around the bladder neck. Electrodes were inserted into the MUS and connected to a programmable pulse generator. After 8 weeks of training the MUS, the pulse generator was programmed to be "on" for 4 hours and "off' for 15 minutes in a continuous cycle. Urodynamic studies were performed periodically, and at the end of the experiment the MUS and proximal urethra were harvested for histology. Three control dogs had sham operations.RESULTS: All MUS's functioned well following the procedure. Histology of the MUS/urethra complex showed no evidence of stricture. Except for one dog, all urethras were easily catheterized.CONCLUSIONS: This electrically stimulated innervated free-flap MUS technique effectively increases bladder outlet resistance without producing urethral obstruction.

KW - Animals

KW - Dogs

KW - Electric Stimulation

KW - Female

KW - Muscle, Skeletal

KW - Surgical Flaps

KW - Urethra

KW - Urinary Incontinence

KW - Urologic Surgical Procedures

KW - GRACILIS SPHINCTER

KW - INCONTINENCE

KW - EXPERIENCE

KW - CHILDREN

KW - MUSCLE

KW - FLAP

U2 - 10.1016/S0022-5347(01)62434-0

DO - 10.1016/S0022-5347(01)62434-0

M3 - Article

C2 - 9783976

SN - 0022-5347

VL - 160

SP - 1867

EP - 1871

JO - Journal of Urology

JF - Journal of Urology

IS - 5

ER -

Muscular urinary sphincter: electrically stimulated myoplasty for functional sphincter reconstruction

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