Figure 1

A. The drawing represents the intervention: the lower 10% of the right gluteus maximus muscles and fascia are mobilized and distally freed in two strips; these are tunnelled beneath the skin and secured to their contralateral counterparts through lateral incision on the contralateral side of the anus. On the right we compared surgical procedure and an MRI carried on one month later. The fibers of the gluteus maximus can be seen surrounding the rectum therefore providing a neo-sphincter. B. Pre-operative picture. The patient is in prone jack-knife position. On the right gluteus a scar from previous surgery is observed. C. The Durasphere^® is injected in the submucosal space. D. Control of bulking effect at the end of the procedure.