Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Repeat Marshall-Marchetti procedure for recurrent stress urinary incontinence.

R A Lee, R E Symmonds

    American Journal of Obstetrics and Gynecology
    |May 1, 1975
    PubMed
    Summary

    This study revisits the Marshall-Marchetti-Krantz (MMK) procedure for recurrent stress incontinence. A transvesical approach revealed many prior MMK surgeries were inadequate, but a revised suspension technique achieved continence in 32 of 36 patients.

    Related Concept Videos

    You might also read

    Related Articles

    Articles linked to this work by shared authors, journal, and citation graph.

    Sort by
    Same author

    A COVID-19 monitoring process for healthcare workers utilizing occupational health.

    Occupational medicine (Oxford, England)·2023
    Same author

    Test Performance and Potential Clinical Utility of the GenMark Dx ePlex Blood Culture Identification Gram-Negative Panel.

    Microbiology spectrum·2023
    Same author

    Analytical performance and potential clinical utility of the GenMark Dx ePlex® blood culture identification gram-positive panel.

    Diagnostic microbiology and infectious disease·2022
    Same author

    Hepatic Sarcoidosis: Diagnostic approach and management.

    The Medical journal of Malaysia·2021
    Same author

    A Case of Severe Falciparum Malaria in a Returned Traveler.

    Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia·2020
    Same author

    Dermatomyositis and nasopharyngeal carcinoma.

    QJM : monthly journal of the Association of Physicians·2020

    Area of Science:

    • Urology
    • Gynecology

    Background:

    • Recurrent stress urinary incontinence presents a significant challenge, often necessitating complex surgical revisions.
    • Previous surgical interventions, including the Marshall-Marchetti-Krantz (MMK) procedure, may not always yield lasting results.
    • Assessing the effectiveness of prior surgeries is crucial for planning successful re-interventions.

    Purpose of the Study:

    • To evaluate the efficacy of a revised surgical approach for recurrent stress urinary incontinence in patients with a history of prior procedures, including the MMK operation.
    • To investigate the anatomical findings during transvesical dissection in patients with alleged prior MMK operations.
    • To assess the functional outcomes of a modified suspension technique combined with plication and bladder revision.

    Main Methods:

    Related Experiment Videos

  • A cohort of 36 patients with recurrent stress incontinence and a history of at least one prior Marshall-Marchetti-Krantz (MMK) operation were included.
  • A transvesical surgical approach was employed to assess the bladder neck, proximal urethra, and the effects of prior sutures.
  • Surgical revision involved repeated suspension augmented by plication and bladder revision.

    • Main Results:

    • Operative dissection revealed a lack of expected adhesions or scarring in the periurethral and vesical neck regions in most patients, suggesting inadequate prior MMK procedures.
    • The transvesical approach allowed for accurate assessment of bladder neck and proximal urethral integrity.
    • Thirty-two out of 36 patients (88.9%) achieved continence following the revised suspension, plication, and bladder revision procedure.

    Conclusions:

    • The transvesical approach is valuable for assessing the integrity of the bladder neck and urethra in patients undergoing revision surgery for stress incontinence.
    • Many previously performed Marshall-Marchetti-Krantz (MMK) operations may be technically inadequate, contributing to recurrent incontinence.
    • A revised surgical strategy involving suspension, plication, and bladder revision demonstrates high efficacy in restoring continence for complex cases of recurrent stress urinary incontinence.