An anal sphincter replacement graft can be carried out when sphincter lesions occur after unsuccessful conservative or other treatment.Today,two different techniques are used to take over the function of the sphincter. The dynamic gracilis graft can be carried out if a non-atrophied, well innervated m. gracilis is present. This technique is carried out on patients whose incontinence is the result of a trauma, pudendopathy or imperforate anus. It can be extended to the construction of a neo-anus after abdominal resection. The artificial anal sphincter is used whenever the previous method fails or can not be used due to a non-vital, denervated or the lack of the m. gracilis. Older methods such as non-stimulated gracilis, glureus or Thiersch grafts are not commonly used.