[ XXXX in @entity7890 and @entity1494 with special reference to free autologous muscle transplantation].

@entity1 @entity25248 @entity322 @entity1494 @entity7890
This is a report on 16 @entity1 with @entity7890 of grades II to IV and on 35 @entity1 with @entity1494 , grades III and IV. The following surgical treatment was carried out: in @entity1 with @entity7890 , simple closure of the urethra in one case, neck of the bladder plasty according to Young-Dees in two cases, the method after Thiersch-Duplay in three cases, whereas four @entity1 were treated after Williams, five after Johnston and one @entity1 after Ombr  danne in reverse. Seven additional operations were done mainly for prepuce correction and closure of fistula after urethroplasty. Three of the 16 @entity1 were continent already before the operation. 4 @entity1 were partially continent. Two of these showed improved continence, thus achieving prolonged periods of dryness. 9 @entity1 remained incontinent. Hence, free muscle transplantation to the bladder was performed in four @entity1 . A total of 45 operations were performed on @entity1 with @entity1494 . Of these, 12 concerned primary closure of bladder; in 13 cases, an ileum bladder was constructed, whereas cystosigmoideostomy was done in 5 times, uretersigmoideostomy 5 times, cutaneous ureterostomy once, rectum bladder once, and a colon conduit once. The postoperative continence performance of the 12 @entity1 with primary bladder closure was unsatisfactory. Three @entity1 only attained periods of dryness up to two hours; 5 remained completely incontinent, whereas in 4 it was subsequently necessary to construct a urinary passage into the intestine by means of an ileum bladder in 2 cases, a colon conduit in one case, and ureterosigmoideostomy in one case. Free muscle transplantation to the bladder was performed in two @entity1 . Free muscle transplants were also performed on 2 @entity1 , in one case after traumatic tearoff of the urethra and in one case after iatrogenic lesion of the musculus sphincter vesicae externus in @entity25248 ( @entity25248 ) according to Prader III and IV. This means that a total of eight free muscle transplants were performed. All @entity1 were primarily incontinent. Postoperatively, complete continence could be achieved in four cases, once an improvement with dry periods up to 2 hours. The two @entity1 with @entity1494 remain incontinent, in one @entity1 with @entity7890 the postoperative interval has been too short so far to arrive at a final judgement. It follows from the examinations that free muscle transplantation is a good method for treating @entity322 , the suspension effect playing an important part. However, in @entity1 with @entity1494 the indication should be considered with caution.
