Ball urethroplasty combined with Marshall-Marchetti-Krantz urethropexy versus suburethral sling in patients with intrinsic sphincter deficiency and urethral hypermobility

OBJECTIVE: It was our goal to compare the efficacy of a suburethral fascial sling with that of a combination of-Marshall-Marchetti-Krantz urethropexy and Ball urethroplasty in patients with intrinsic sphincter deficiency and urethral hypermobility. STUDY DESIGN: This study consisted of a retrospective observational evaluat ion of patients from 2 separate practice sites. Preoperative and postoperat ive data were collected from patients' medical records. The long-term resul ts were based on a mailed questionnaire addressing bladder symptoms and qua lity-of-life issues. RESULTS: Among a total of 48 patients, 37 (77. 1 %) responded in the group undergoing Marshall-Marchetti-Krantz urethropexy combined with Ball urethro plasty, and 30 out of 35 (85.7%) patients replied in the suburethral fascia l sling group. The mean length of follow-up was 2.7 years (range, 1-5 years ). The patients were similar in age, hormonal status, parity, and previous bladder neck surgery. Similar cure and improvement were demonstrated in bot h groups (86.6% in the suburethral fascia group and 89.2% in the group with the Marshall-Marchetti-Krantz procedure combined with Ball urethroplasty). No significant differences were found in urinary incontinence types, irrit able bladder symptoms, voiding difficulties, or quality-of-life measures. CONCLUSIONS: The suburethral fascial sling and a procedure consisting of Ma rshall-Marchetti-Krantz urethropexy combined with Ball urethroplasty have s imilar results in patients with intrinsic sphincter and urethral hypermobil ity.