Abstract

Within the last three years, Wreden1and I2described a new method of restitution of anal control following damage or loss of the sphincter muscle. At that time Wreden reported one successful case, and I reported one successful and one unsuccessful case; since then Ransohoff3has reported an additional case in which this method was successful. My purpose in the present paper is to record five other cases, to call attention again to this valuable principle of treatment in a most discouraging situation and to introduce some further modifications of technic which seem to be improvements. The essential principle of Wreden's operation is to harness the two gluteus maximus muscles by slings of fascia that pass around the anal canal, in such a manner that when the glutei contract these fascial slings will be drawn taut. As the slings from the two sides interlock, this tightening closes

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