PLASTIC OPERATIONS FOR INCONTINENCE OF URINE AND OF FECES

Incontinence of urine and feces are conditions so distressing to patients and offensive to their associates that it is not surprising that every conceivable method has been employed in attempts to relieve them. In that group of cases in which the incontinence is due simply to the sphincter having been cut across, accurate approximation of the divided ends usually results in complete restoration of function. Even when it has been divided in two or more places, or partially destroyed, operations which restore to use such muscle as remains, completing the ring with fibrous tissue of some sort, are often successful. But when the sphincter has been severely damaged, has been removed altogether, is congenitally absent or has had its nerve supply destroyed, the problem becomes far more difficult, and the prognosis correspondingly poorer. The multiplicity of operations devised only serves to show how earnest but vain has been the search