The replacement of the external anal sphincter by gluteus muscle in fecal incontinence is described in 4 cases. All patients, three children and one adult, had been operated on previously because of different types of anal atresia and suffered from fecal incontinence grade IV. They all showed a congenital defect of the somatic sphincter. The absent external and sphincter muscle was repaired by transposing innervated and vascularized gluteus muscle. In all cases active anal continence was achieved proven by clinical and electromanometric measures. The results, compared to other techniques, are discussed.
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