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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Marshall-Marchetti-Krantz Procedure
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 the term used for
leakage of urine during exercise, coughing, sneezing,
laughing, or lifting.
When is it used?
This operation may be performed if you have trouble holding
urine.
Examples of alternatives are:
- to try exercises to help you control your urine
- to have a mechanical device to help hold urine
- to have a different surgical procedure
- to inject a collagenlike material through the vagina and
under the bladder and urethra
- to choose not to have treatment.
You should ask your doctor about these choices.
How do I prepare for a Marshall-Marchetti-Krantz
procedure?
Plan for your care and recovery after the operation. Allow
for time to rest and try to find other people to help you
with your day-to-day duties.
Follow instructions provided by your doctor. Eat a light
meal, such as soup or salad, the night before the procedure.
Do not eat or drink anything after midnight and the morning
before the procedure. Do not even drink coffee, tea, or
water.
What happens during the procedure?
You will be given a general anesthetic. A general
anesthetic relaxes your muscles, makes you feel as if you
are in a deep sleep, and prevents you from feeling pain.
The doctor will make a cut in your lower abdomen. He or she
will separate the front of the bladder from the tissues
around it and put stitches in the supporting tissue next to
the urethra. (The urethra is the tube that carries urine
outside the body.) The doctor will lift the tissue around
the urethra with a stitch and fasten it to the pubic bone
(the bone in the front part of the pelvis).
The doctor may put a catheter (tube) into your bladder to
drain urine. This tube may pass through the urethra, or the
doctor may insert it through the abdominal wall and into the
bladder. Drains may be inserted through the incision to
prevent infection by releasing any fluid or blood that
collects in the area of the surgery. The doctor will then
close the cut.
Gauze may be put in the vagina. 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, depending on how
quickly you recover from the procedure. The drain will be
removed a couple days after the surgery. The catheter will
stay in your bladder for 4 to 6 days or until your bladder
starts working again.
After going home, do not lift anything heavy (over 10
pounds) and avoid any strenuous activities for 8 to 10
weeks. Ask your doctor what other steps you should take and
when you should come back for a checkup.
What are the benefits of this procedure?
You should be better able to hold urine when you cough,
laugh, sneeze, or exercise.
What are the risks associated with this procedure?
- There are some risks when you have general anesthesia.
Discuss these risks with your doctor.
- The bladder or urethra may be damaged.
- The ureters (the tubes from the kidneys to the bladder)
may be damaged.
- Stones might form in the bladder.
- The operation might not help to hold the urine.
- There may be infection or bleeding.
You should ask your doctor how these risks apply to you.
When should I call the doctor?
Call the doctor immediately if:
- You develop a fever.
- You become dizzy and faint.
- You have nausea and vomiting.
- You become short of breath.
Call the doctor during office hours if:
- You have questions about the procedure or its result.
- You want to make another appointment.
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