Marshall-Marchetti-Krantz Procedure is one of the two primary surgeries to treat stress incontinence. The other procedure is retropubic urethropexy or Burch procedure. The difference between these two procedures is that the Burch procedure uses sutures to attach the urethra and bladder to muscle tissue in the pelvic area. The Marshall-Marchetti-Krantz procedure uses sutures to attach these organs to the pelvic cartilage.
The Marshall-Marchetti-Krantz procedure is performed to reinforce the bladder neck, which prevents unintentional urine loss also known as urinary stress incontinence. Stress incontinence is the unintentional loss of urine prompted by a physical movement or activity, ...view middle of the document...
The bladder is a muscular organ that is vital in the urinary system because it is the organ responsible for holding the urine and keeping it from leaking out of the bladder. (McKenzie)
The Urethra is another important component and the last of the urinary system. The urethra is the passageway where urine flows out of the body. The length varies between men and women; it is longer in men, usually about 6 to 8 inches long. In female anatomy however, the urethra is about 1.5 inches, which is significantly shorter than males and the reason why females are more prone to having urinary tract infections. The shorter distance makes it easier for bacteria and other microorganisms to travel to go up to the urinary tract.
As mentioned above, stress incontinence is the involuntary loss of urine that occurs when the body is engaged in physical activity, such as exercise, sneezing, coughing, or even laughing. In order for the urinary system to function properly, one must have both abilities to hold urine and control urination as well as the ability to recognize when the body gets the urge to urinate. There are two muscles involved in controlling the flow of urine; these are the sphincter and the detrusor. The sphincter is the circular muscle that surrounds the urethra; this is the muscle that is squeezed to prevent the urine from leaking out. The second muscle is the detrusor, which is the muscle of the bladder wall, this is important because it must stay relaxed so that the bladder can expand as it fills with urine. (McKenzie)
The weakening of the sphincter and pelvic muscles causes stress incontinence. The risk factors are; childbirth, aging, chronic coughing or having chronic bronchitis or asthma, obesity, smoking, post-menopause in women. Or it may also be due to a malfunction of the urethral sphincter due to surgery to of the prostate or pelvic area, medications, or injury to the urethral area. Because childbirth and post-menopause may cause stress incontinence, this would mean that stress incontinence is more prevalent in women. Not only is it more common in women, but also it is often seen more in women who have had multiple pregnancies and vaginal deliveries and whom have had a pelvic prolapse, which is when the rectal wall sticks out into the vagina.
The major symptom of stress incontinence is the inability to hold urine when one is engaged in physical activity, which is the involuntary loss of urine. This can occur during coughing, sneezing, exercising, sexual intercourse, and even standing and laughing. In order for a patient to be diagnosed with stress incontinence, a doctor must first perform a physical exam to include a genital exam in men, a pelvic exam in women and a rectal exam. The pelvic exam in women is done to determine whether the bladder or urethra is protruding into the vaginal space, which may be causing the incontinence.
The different tests that can be done are: cystoscopy, which is the inspection of the...