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Indications for surgery were faecal incontinence (n = 11) and reconstruction following sphincter excision or congenital absence (n = 8). Transposition of the gracilis muscle around the anal canal followed by chronic low-frequency electrical stimulation was associated with a shift in the frequency-response curve and a prolongation of the time-course of individual muscle twitches suggestive of transformation to a slow-twitch fatigue-resistant type. Temporary cessation of electrical stimulation resulted in a reversal of the frequency-response changes. Muscle biopsies taken before and a median of 80 (range 49\u2013137) days after transposition and low-frequency electrical stimulation indicated a significant increase in the proportion of type 1 fibres and a significant decrease in their diameter. These results show that the human gracilis muscle is capable of physiological and histochemical adaptation to long-term neosphincter function.<\/jats:p>","DOI":"10.1002\/bjs.1800801042","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T17:33:31Z","timestamp":1172943211000},"page":"1342-1346","source":"Crossref","is-referenced-by-count":51,"title":["Physiological and histochemical adaptation of the electrically stimulated gracilis muscle to neoanal sphincter function"],"prefix":"10.1093","volume":"80","author":[{"given":"B D","family":"George","sequence":"first","affiliation":[{"name":"Department of Surgery, The Royal London Hospital , London E1 1BB,","place":["UK"]}]},{"given":"N S","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Royal London Hospital , London E1 1BB,","place":["UK"]}]},{"given":"J","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Royal London Hospital , London E1 1BB,","place":["UK"]}]},{"given":"M","family":"Swash","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Royal London Hospital , London E1 1BB,","place":["UK"]}]},{"given":"E S","family":"Watkins","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Royal London Hospital , London E1 1BB,","place":["UK"]}]}],"member":"286","published-online":{"date-parts":[[1993,10,1]]},"reference":[{"key":"2024092812023611500_bib1","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1097\/00006534-198207000-00017","article-title":"Construction of a rectal sphincter using the origin of the gluteus maximus muscle","volume":"70","author":"Hentz","year":"1982","journal-title":"Plast Reconstr Surg"},{"key":"2024092812023611500_bib2","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1097\/00000658-195508000-00013","article-title":"The use of superficial transverse perineal muscles in the treatment of post-surgical anal incontinence","volume":"142","author":"State","year":"1955","journal-title":"Ann Surg"},{"key":"2024092812023611500_bib3","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1097\/00000658-195206000-00010","article-title":"Construction of a rectal sphincter and restoration of anal continence by transplanting the gracilis muscle","volume":"135","author":"Pickrell","year":"1952","journal-title":"Ann Surg"},{"key":"2024092812023611500_bib4","first-page":"317","article-title":"The internal obturator muscles functioning as the neosphincter of the anus. 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