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TRANSPLANTATION OF THE GRACILIS MUSCLE FOR INCONTINENCE OF URINE

CLYDE LEROY DEMING, M.D.
JAMA. 1926;86(12):822-825. doi:10.1001/jama.1926.02670380012007.
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My object in this paper is to describe a new plastic operation for the control of urination in the absence of sphincters to the bladder. We know that either one of the normal sphincters is capable of producing continence of urination. When both are absent, we may expect that one artificial sphincter will suffice for this function, if properly constructed. Orthopedists have little difficulty in causing transplanted muscles to perform foreign tasks. Such transplantations and the course of action are practically always in a straight line. Unfortunately, we have no muscles with normal sphincter action per se which we can transplant into the neck of the bladder. The employment of straight bellied muscles for a complication of movements such as seen in a diaphragm has baffled many surgeons. The rectus muscle is used successfully in colostomies, but its action is a straight contraction, not a sphincteric one. There are no

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