Comparison of modified MMK Operation vs Kelly’s Plication for female stress incontinence

Abstract

OBJECTIVES: To compare the results of modified MMK operation with vaginal repair in female stress incontinence and to study the prognostic variables that determine the success. MATERIALS AND METHODS: Urinary stress incontinence was treated by modified MMK operation in 59 and by Kelly’s vaginal repair in 42 women. All were assessed preoperatively by detailed history, clinical examination. No sophisticated urodynamic studies were done. Follow up was done initially at 3 months, then at 6 and 12 months. RESULTS: Better results were obtained with modified MMK operation (88.1%) compared to vaginal repair (69%). Results were excellent in type I incontinence and in the absence of pelvic floor relaxation. Hysterectomy did not seem to improve the results. Complication rates were acceptable with modified MMK operation. CONCLUSION: Though laparoscopic Burch colposuspension is the preferred management in female urinary stress incontinence, this modality is not available at all centers. For institutions which provide basic gynaecological services, we recommend modified MMK operation as a primary surgery for female urinary stress incontinence to obtain higher cure rates and to minimize the incidence of recurrent urinary stress incontinence following vaginal repair. KEY WORDS: Stress incontinence, Kelly’s repair, modified MMK operation