Modification of Marshall-Marchetti-Krantz operation.

In a classic article published in 1949 Marshall, Marchetti, and Krantz demonstrated that stress incontinence in women without uterine prolapse could be corrected by a simple vesicourethral suspension. Beginning in 1960 one of the authors (W.E.C.) became concerned about suturing the urethra to the periosteum of the pubis. It occurred to him that use of the upper sutures only to pull up the bladder and hold its anterior wall to the back of the rectus muscles might be just as effective, and this has proved to be so.