Through the years the Marshall-Marchetti-Krantz procedure has proved to be one of the most important contributions to the surgical management of stress incontinence. The purpose of this communication is to illustrate a simplified technique that, in our experience, has proved to be successful. The triple-bite, single-suture technique achieves the resuspension of the urethra and bladder neck using only one suture on each side of the urethra as compared with an average of three sutures when the standard procedure is used. It has the advantage of simplifying the operation saving time, preventing the confusion of multiple sutures. Also, there is less tissue manipulation, decreased blood loss from this highly vascular area and reduced possibility of infection. Inasmuch as only two sutures are place in the symphysis pubis, the opportunity for the development of osteitis pubis is diminished. The elevation of the urethra and the vesicourethral angle is excellent as is demonstrated in our patients through the use of properative and postoperative metallic chain cystourethrogram. In the past eighteen months we have performed the triple-bite, single-suture technique on 23 patients. All of the patients had a preoperative chain cystourethrogram to document a Type II anatomical defect. The postoperative chain cystourethrogram in all 23 cases invariably shows the normal restoration of the posterior urethrovesical angle and urethral axis. Figure 2 shows the x-ray study in a 40-year old female who had urinary stress incontinence for four years.
|Original language||English (US)|
|Number of pages||4|
|Journal||Journal of the Medical Society of New Jersey|
|State||Published - Dec 1 1977|
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