Bladder and urethral repair

Alternative names:

Marshall-Marchetti operation; MMK; urethral suspension; vesicourethral suspension

Definition:

Surgery to control involuntary urination by elevating the urethra and bladder.

Description:

Bladder and urethral repair is usually performed to prevent urine leakage associated with stress incontinence (involuntary leakage of urine when laughing, coughing, sneezing, or lifting, which can result from deformity or damage to the urethra and bladder from decreased muscle tone caused by multiple births, menopause, or other causes). This surgery is performed using general anesthesia. The bladder neck (pubococcygeal muscle) is elevated by stitching it and the urethra to the anterior (front) pubic bone.

You will return from surgery with a foley catheter and a suprapubic catheter in place. The urine may initially appear bloody but this should gradually resolve. The suprapubic catheter may be removed several days after surgery when you are able to completely empty your bladder. Often this suprapubic catheter will need remain in place for as long as 3 months, depending on the person's ability to empty the bladder completely.

You will also return from surgery with a large abdominal dressing covering the incisional area. This dressing will remain in place for about three days. The stitches are usually removed during the first office visit after surgery. Often, you will return from surgery with a drainage tube in the lower abdominal or rectal area to drain excess fluid and blood from the abdominal cavity. This drain is usually removed about 3 days after surgery when the drainage has decreased.

Indications:

Repair of the bladder and urethra may be recommended for treatment of stress incontinence (inability to prevent urine leakage when coughing, sneezing, laughing, jumping, walking, sitting, or standing).