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Modified Marshall, Marchetti and Krantz operation
Abstract:
A modification of the Marshall, Marchetti and Krantz procedure is described that uses the Babcock clamp for exposure and the rectus muscle for suspension in order to reduce the complications and technical difficulties. The procedure was utilized for 30 patients, and in the same period 27 patients were treated with the nonmodified procedure. A follow-up from one to six years resulted in one patient with a complete failure and another with a partial failure in the modified group and five patients with complete failure in the nonmodified group. The complications rates were essentially the same. However, in the nonmodified group there was one patient with osteitis pubis, one patient with urethral stenosis and two patients with prolonged urinary retention. The results suggest that the modified technique is simple and successful in correcting stress urinary incontinence in women if coupled with adequate study of the patient and careful selection of the treatment.
Insights
A modified Marshall, Marchetti and Krantz procedure using the Babcock clamp and rectus muscle suspension shows high success in treating stress urinary incontinence in women, with fewer failures than the traditional method.
Area of Science:
- Urology
- Gynecology
- Surgical Innovation
Background:
- Stress urinary incontinence (SUI) significantly impacts women's quality of life.
- The Marshall, Marchetti and Krantz (MMK) procedure is a common surgical treatment for SUI.
- Technical difficulties and complications can arise with the traditional MMK procedure.
Purpose of the Study:
- To describe a modified MMK procedure using the Babcock clamp for exposure and rectus muscle for suspension.
- To evaluate the efficacy and safety of this modified technique compared to the nonmodified procedure for SUI treatment.
Main Methods:
- A modified MMK procedure was performed on 30 patients.
- A control group of 27 patients underwent the nonmodified MMK procedure.
- Patient outcomes and complications were assessed during follow-up ranging from one to six years.
Main Results:
- The modified group experienced only one complete failure and one partial failure.
- The nonmodified group had five complete failures.
- Complication rates were similar between groups, but the nonmodified group reported specific issues like osteitis pubis and urethral stenosis.
Conclusions:
- The modified MMK procedure is a simple and effective surgical option for correcting SUI in women.
- Careful patient selection and study are crucial for successful outcomes with the modified technique.