Transpubic suspension of the bladder neck for urinary incontinence

We present a modification of the classic Marshall-Marchetti-Krantz procedure in which only 1 pair of sutures is used. Each suture snugs the periurethral tissue of the anterior vaginal wall on each side to the posterior surface of the symphysis pubis and ipsilateral pubic bone by passing the suture through a hole drilled in each respective pubic bone. Complications have been temporary difficulty in voiding after the catheter has been removed and an occasional incisional hernia. Osteitis pubis has not been a problem possibly because of the use of wide-spectrum antibiotics.