Comparison of the Marshall-Marchetti and endoscopic bladder neck suspension for stress incontinence

Chung, Chan Euy; Yoon, Moon Soo; Park, Yong Hyun; Lim, Soo Kil

Abstract

The MsrshaII-Marchetti and endoscopic bladder neck suspension procedure are successful procedures for the treatment of genuine stress incontinence. We experienced 32 cases of stress incontinence surgically treated by the Marshall-Marchetti procedure (7 cases) during the period from January 1973 to 1981 and endoscopic bladder neck suspension procedure (25 cases) from l982 to June l990. Following results were obtained. I. Patients' ages ranged from 15 to 63 years (average 46.6 years), and most patients were rnultiparous with an average of 3.5 deliveries. 2. On the chain cystourethrogram. 25 cases (78.1%) belonged to type I , and seven case.s (2l.9%) to type I[ according to Green`s classification. 3. The values of postoperative days on catheter, operative time and postoperative hospitalization in the Marshall-Marchetti procedure were 6.7+/-3.3 days, 112.9+/-20.6 minutes and 8.7+/-0.8 days, and in the endoscopic bladder neck suspension procedure 3.3+/-2.0, 87.9+/-22.9 and 45+/-2.0 respectively (P<0.05). 4. Postoperative complications were minimal except urinary retention in I4 out of 25 cases (56%) undergoing the endoscopic bladder neck suspension procedure, and nine of them (64.3%) were restored to normal voiding pattern within two weeks by intermittent catheterization. 5. The success rate was 85.7% in the Marshall-Marchetti, and 91.3% in the endoscopic bladder neck suspension procedure with a minimum follow up of six months. With above results. we concluded that the endoscopic bladder neck suspension procedure had advantages including operative simplicity, extensive indication, a high rate of cure, short hospitalization and postoperative catheter drainage compared with the Marshall-Marchetti procedure.