Free Autogenous Muscle Transplantation in Urinary Incontinence

24 patients with severe urinary incontinence were treated by means of free autogenous muscle transplantation. 11 patients had bladder exstrophy and 9 patients epispadias. Before transplantation, they were already operated once or several times with reconstructions and plasties. 3 patients were incontinent after resection of urethral valves. The follow-up period was between land 7 years. The results were good in 14 patients implying increasing functional bladder capacity and abandoning of napkins during the day. 4 patients were improved and 6 were failures. Most patients exhibited normal urinary flow postoperatively. Cine studies of micturition clearly showed activity of the transplants with contractility and ability to relax the transplanted sling. In boys, erection was unimpaired postoperatively. The earliest signs of improvement appeared 2-6 months after surgery. Most patients showed further improvement 2 years post-operatively.