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Marshall-Marchetti-Krantz Procedure


 What is a Marshall-Marchetti-Krantz procedure?
 When is it used?
 How do I prepare for this procedure?
 What happens during the procedure?
 What happens after the procedure?
 What are the risks of this procedure?

Female Pelvis: Illustration
Female Pelvis: IllustrationClick here to view a full size picture.

Urinary System: Illustration
Urinary System: IllustrationClick here to view a full size picture.

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KEY POINTS

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What is a Marshall-Marchetti-Krantz procedure?

The Marshall-Marchetti-Krantz procedure is a type of surgery done to help a bladder control problem called stress incontinence. Stress incontinence is leaking of urine during exercise, coughing, sneezing, laughing, or lifting.

When is it used?

This surgery may be done if you have trouble holding urine. Your healthcare provider may recommend surgery when attempts to strengthen the muscles and tissues around the bladder with exercise or other treatments have not helped. After the surgery you should be able to urinate normally again. You may be able to go back to your usual activities without leaking urine. Bulging and feelings of pressure in the vagina will be relieved.

Instead of this procedure, other treatments to relieve symptoms may include:

Surgery is usually done only after you have tried other treatments.

You may choose not to have treatment. Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

What happens during the procedure?

The surgery will be done at the hospital.

You will be given a general anesthetic. General anesthesia relaxes your muscles and you will be asleep.

Your healthcare provider will make a cut (incision) in your lower belly. Your provider will lift the tissue around the urethra (the tube that carries urine out of the body) with a stitch and fasten it to the bone in the front part of the pelvis and to tissue behind the abdominal wall.

Your provider may put a catheter (tube) into your bladder to drain urine. This tube may pass through the urethra, or the surgeon may insert it through a cut in the wall of your lower belly. Drains may be inserted through the incision to prevent infection by releasing any fluid or blood that collects in the area of the surgery. Your provider will then close the cut.

The surgeon may put gauze in your vagina. The gauze helps the bladder and urethra stay in place while the tissue starts healing. It also helps prevent bleeding. The gauze will be removed 2 to 3 days after the surgery.

What happens after the procedure?

You may stay in the hospital 2 to 6 days.

The drain in your incision will be removed when fluid is no longer leaking from your incision.

You may need to go home with a catheter in your bladder until the bladder is working normally again. Your healthcare provider will decide when the catheter can be removed during a follow-up visit.

Constipation is common after surgery because of some medicines and inactivity. Eating fruits and vegetables and drinking extra fluids may help you avoid constipation. If diet and extra fluids are not enough to avoid constipation, your provider may recommend a stool softener or a laxative. Check with your healthcare provider if constipation keeps being a problem.

You may have some bloody or pink drainage from your vagina for a few weeks.

Ask your healthcare provider:

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.

healthinformatics info

References

ACOG Practice Bulletin: Urinary Incontinence in Women, Number 63, June 2005. Reaffirmed, 2013.

Lentz,G., R. Lobo, D. Gershenson, V. Katz. Comprehensive Gynecology. 6th ed. Mosby Elsevier, 2012.

Schorge, J., et al. Williams Gynecology. 2nd ed. The Mcgraw Hill Companies, Inc. 2012.

Jelovsek, E. et al. Surgical Management of stress urinary incontinence in women: choosing a primary surgical procedure. Last literature review and update March/April 2015. UptoDate.com, accessed April 13, 2015.


Related Topics

Marshall-Marchetti-Krantz Procedure

Cystocele

Cystocele Repair

Cystocele and Rectocele Repair

Kegel Exercises

Pelvic Support Problems

Stress Incontinence in Women

Vaginal Pessary


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Last Modified: 2015-04-16

Last Reviewed: 2015-04-16

Website Updated: August 2015

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This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.


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