Topographic modifications of the urethrovesical junction and proximal urethra after combined Marshall-Marchetti-Krantz and Burch surgery

• Published in: Revista Brasileira de ginecologia e obstetrícia Vol. 31; no. 8; pp. 391 - 396
• Main Authors: Alencar, Arinaldo Vasconcelos de, Brandt, Frederico Teixeira, Costa, Hélio de Lima Ferreira Fernandes, Albuquerque, Carla Daisy, Costa, Rosângela Falcão da, Alencar, Saulo Barbosa Vasconcelos de
• Format: Journal Article
• Language: Portuguese
• Published: Brazil 01-08-2009
• Subjects: Adult; Aged; Female; Humans; Middle Aged; Prospective Studies; Ultrasonography; Urethra - diagnostic imaging; Urethra - pathology; Urinary Bladder - diagnostic imaging; Urinary Bladder - pathology; Urinary Incontinence, Stress - surgery; Urologic Surgical Procedures - methods
• DOI: 10.1590/S0100-72032009000800004
• EISSN: 1806-9339

To study the changes in the urethrovesical junction (UVJ) and in the proximal urethra (PU) caused by the Marshall-Marchetti-Krantz-Burch (MMK-B) combined surgery through perineal ultrasonography.
An interventional, longitudinal and prospective study has been conducted. Thirty-two women with stress urinary incontinence were submitted to perineal ultrasonography before and 30 days after surgery to evaluate the pubo-urethral distance (PUD), the proximal urethra length, the UVJ horizontal distance (UVJHD) and the UVJ vertical distance (UVJVD), the patient being at rest, and in effort during the Valsava manoeuvre. Results have been expressed in mean and standard deviation. The Student's t-test has been used to compare pre and postoperative results whenever the variables fulfilled the normality test criterion; otherwise, the Wilcoxon's paired test has been used.
As compared with the preoperative measures, the Marshall-Marchetti-Krantz-Burch surgery has reduced the PUD at rest (14 mm x 4.3 mm) and during effort (20.8 mm x 6.4 mm); has reduced the UVJHD at rest (14 mm x 4.3 mm) and during effort (20.8 mm x 6.4 mm); has increased the PU length at rest (16.7 mm x 19.7 mm) and during effort (1.6 mm x 15.4 mm); and has increased UVJVD during effort (-5.4 mm x 14.8 mm), but has not changed it at rest (16.2 mm x 18.7 mm, p = 0.085).
The Marshall-Marchetti-Krantz-Burch surgery has significantly reduced the urethrovesical junction vertical and horizontal mobility without raising the urethrovesical junction.