Marshall-Marchetti-Krantz Procedure

The Marshall-Marchetti-Krantz procedure is surgery to correct uncontrolled urine loss (urinary incontinence) in women. Women with urinary incontinence often have urine loss during exercise, laughing, coughing, sneezing, and sexual intercourse. Urinary incontinence is usually seen in women who have had vaginal deliveries and in menopausal women. It occurs because of a lack of estrogen and the weakening of the muscle and ligament tissue around the bladder and urethra.

LET YOUR HEALTH CARE PROVIDER KNOW ABOUT:

  • Any allergies you have.

  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.

  • Previous problems you or members of your family have had with the use of anesthetics.

  • Any blood disorders you have.

  • Previous surgeries you have had.

  • Medical conditions you have.

RISKS AND COMPLICATIONS

Generally, this is a safe procedure. However, as with any procedure, complications can occur. Possible complications include:

  • Injury to the bladder, urethra, or surrounding organs.

  • Excessive bleeding.

  • Infection.

  • Problems related to anesthesia.

  • You may have difficulty urinating or may have leaking of urine again.

BEFORE THE PROCEDURE

  • Various tests may need to be done before the day of surgery, such as:

  • Blood tests.

  • X-ray exams.

  • Ultrasonography.

  • Bladder and urinating tests (urodynamic testing).

  • Cystoscopy. This is a test to look into your bladder using a small metal scope with a light.

  • Ask your health care provider about changing or stopping your regular medicines. You may need to stop taking certain medicines, such as aspirin or blood thinners, a week before your surgery.

  • Do not eat or drink anything for 8 hours before your surgery.

  • If you smoke, do not smoke for at least 2 weeks before surgery. Smokers do not heal as well and tend to have more breathing problems during and after surgery.

  • Make plans to have someone drive you home after your hospital stay. Also arrange for someone to help you with activities during recovery.

PROCEDURE

  • An IV tube will be placed in one of your veins. You will be given a medicine to help you relax before the procedure (sedative). You will then be given a medicine to make you sleep during the procedure (general anesthetic).

  • Your lower abdomen will be shaved and washed with an antiseptic soap. A thin, flexible tube (catheter) will be placed in your bladder through the urethra.

  • An incision is made above the pubic bone.

  • Stitches are placed in the tissue and ligaments around the bladder and urethra to elevate the bladder neck. The bladder neck is sutured to the back of the pubic bone and ligaments behind the pubic bone.

  • The incision is closed with stitches.

AFTER THE PROCEDURE

  • You may have gauze or bandages (dressings) in the vagina. This will be removed in 1–2 days along with the IV tube.

  • The catheter will stay in your bladder until you are urinating normally, which usually takes 4–6 days.

  • You will be given antibiotic medicine and pain medicine, if needed.

  • You will likely need to stay in the hospital for 2–5 days.