PTU - Polskie Towarzystwo Urologiczne
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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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