LONG-TERM SUBJECTIVE RESULTS OF MARSHALL-MARCHETTI-KRANTZ PROCEDURE

Objective: Retrospective, subjective evaluation of results of suprapub ic vesicourethropexy (Marshall-Marchetti-Krantz procedure) for stress urinary incontinence. Material: A total number of 81 patient records o perated between 1980 and 1994 at our institution were reviewed and que stionnaires were mailed to them to estimate the success rate, period o f continence, current complaints and patient satisfaction. Patients wi th primary incontinence constituted 73% of this group, the remainder o f 27% being recurrent or persistent incontinence. Results: The respons e rate was 75% (60 cases) and this group was evaluated. Mean postopera tive time was 9.9 (2-15) years at the time of assessment. Mean duratio n of continence was 78.5 months and was not influenced by prior hyster ectomy or parity. Weak correlation was found between patients' age and continence period. It was similar in patients operated in their 5th a nd 6th decades of life and was shorter in the 7th decade. Additional s utures placed between the anterior bladder wall and rectus fascia (Lap ides modification) resulted in a longer continence period. Cure rates decreased with time and were 81, 77, 57 and 28% after 6, 12, 60 and 12 0 months respectively. In the incontinent group, 34% of patients descr ibed leakage degree as lesser than preoperatively and 65% required pro tection. As many as 90% of continent and 62% of incontinent women eval uated their urinary system status as better than preoperatively. 90% o f continent and 69% of incontinent women would repeat surgery again. C onclusions: This procedure is characterized by a high 81% early postop erative success rate that decreases with time. Despite recurrence of s tress incontinence: one third of patients declare lesser incontinence degree and do not require protection.