RESULTS OF MARSCHALL-MARCHETTI-KRANTZ PROCEDURE
FOR STRESS URINARY INCONTINENCE
- A SUBJECTIVE EVALUATION
Article published in Urologia Polska 1997/50/2.
Maciej Czaplicki, Piotr Dobroński, Cezary Torz, Andrzej Borkowski
- Katedra i Klinika Urologii Akademii Medycznej w Warszawie
Kierownik Kliniki: prof dr n. med. Andrzej Borkowski
stress urinary incontinence ? treatment, vesicourethrosuspension ? Marshall-Marchetti-Krantz procedure ? subjective evaluation
- Objective. Retrospective, subjective evaluation of results and ±uality of life of patients
- who underwent suprapubic vesicourethropexy (Marshall-Marchetti-Krantz procedure)
- for stress urinary incontinence.
- Material and methods. A total number of 81 records of patients operated on between
- 1980 and 1994 at our institution were reviewed and ±uestionnaire were mailed to estimate
- the success rate, period of continence, current complaints and patient satisfaction. Primary
- stress urinary incontinence constituted 73% patients of this group, the remainder of
- 27% being recurrent or persistent incontinence.
- Results. The response rate was 75% (60 cases) and this group was evaluated. Mean
- postoperative time was 9.9 (2-15) years at the time of assessment. Mean continence
- time was 78.5 months and was not influenced by previous hysterectomy or labors and
- only weak correlation was found with patients age. Continence duration was similar
- for patients operated in their 50-ies and 60-ies and was shorter for patients operated in
- 7th decade of life. Additional sutures placed between anterior bladder wall and rectus
- fascia (Lapides modification) resulted in longer continence period. Cure rates decreased
- with time and after 6,12,60 and 120 months were 81 %, 77%, 57% and 28% respectively.
- In the incontinent group 34% of patients described leakage degree as less than
- preoperatively and 65% re±uired Protection. Urinary symptoms and dyspareunia rates
- in both continent and incontinent groups were compared. In general 90% of continent
- and 62% of incontinent women evaluated their urinary system status as better than
- preoperatively. If they had a choice, 90% of continent and 69% of incontinent women
- would have chosen surgery again.
- Conclusions.This procedure is characterized by 81% early postoperative success
- rate that decreases with time to 57% after 5 and 28% after 10 years. Mean 78.5 month
- continence time does not depend on previous hysterectomy and labors and is shorter in
- women operated in their 70-ies. Despite of recurrence of stress incontinence 1/3 of
- patients declare lesser incontinence degree and do not re±uire Protection.
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