[Urodynamic observations on the Marshall-Marchetti-Krantz operation].

Urodynamic tests and clinical and anamnestic assessments of continence were carried out in 47 patients before and after the Marshall-Marchetti-Krantz operation. The operation resulted in a subjective cure in 35 (74.5%) of the patients; 12 women were again incontinent within a period of between 6 and 24 months. There was an insignificant postoperative rise in urethral occlusion pressure at rest. It was only possible to ensure an elongation of the urethra in the resting pressure curve. The urethral occlusion pressure at rest in patients with recurrent incontinence was considerably lower preoperatively than in postoperatively continent patients. Hence, high urethral occlusion pressure at rest signifies a good surgical prognosis. In the stress pressure curve, surgery improved the transmission factor, the depression factor, and the urethral occlusion pressure under stress. However, no clear surgical prognosis was possible on the basis of these parameters. The best postoperative results for the transmission and depression factors and the urethral occlusion pressure under stress were obtained in the stress pressure curve at 300 ml with the patient in seated position. On comparing preoperative and postoperative measurements, improvements in pressure transmission and in urethral occlusion pressure under stress were seen in particular in the proximal one-third of the urethra. Hence, the question arises whether the proximal one-third of the urethra is as important as the medial one-third in stress incontinence diagnosis by measurement.