Marshall-Marchetti-Krantz urethropexy and Burch colposuspension for stressurinary incontinence in women with low pressure and hypermobility of the urethra: Early results of a prospective randomized clinical trial

OBJECTIVE: The aim of the study was to compare the effects of Burch colposu spension and Marshall-Marchetti-Krantz urethropexy with videourethroscopic control in the correction of stress urinary incontinence in patients with l ow pressure and hypermobility of the urethra. STUDY DESIGN: Thirty women were randomly assigned to undergo 1 of the 2 sur gical procedures from November 1993 to May 1996 (15 Burch colposuspensions and 15 Marshall-Marchetti-Krantz urethropexies) and were evaluated subjecti vely and objectively for stress urinary incontinence at 2 and 12 months. Da ta obtained were analyzed with the Student t test, the Fisher exact test, a nd the Wilcoxon signed rank test. RESULTS: At 1 year of follow-up 15 women in the Marshall-Marchetti-Krantz u rethropexy group (100%) and 10 women in the Burch colposuspension group (66 %) were subjectively considered cured (P = .02, 2-tailed Fisher exact test) , and stress test results were negative in 14 women (93%) and 8 women (53%) , respectively (P = .017, 2-tailed Fisher exact test). The resumption of sp ontaneous voiding was attained after 6.5 +/- 3.3 days in the Burch colposus pension group and in 20.5 +/- 13.4 days in the Marshall-Marchetti-Krantz ur ethropexy group (P < .001, 2-tailed Wilcoxon rank sum test). CONCLUSION: The high cure rate and low associated morbidity mark the Marsha ll-Marchetti-Krantz procedure with videourethroscopic control as more effec tive than Burch colposuspension in repairing stress urinary incontinence as sociated with low pressure and hypermobility of the urethra.