aboutspacecollectionsspaceexhibitsspacemilestonesspacepressspace
antibiotics
bph
catheterization
chemotherapy
cystoscopy
ht
imaging
incontinence
infertility
prostatectomy
psa
sd
stonedisease
The treatment of incontinence has involved numerous devices, some of them effective, some not.  Centuries ago, patients suffering from urinary incontinence wore bags to catch leaking urine, as shown in this Middle Ages woodcut.

Today's most popular operations for stress incontinence, have roots in the 1900s and address a common theme: to support the bladder neck and urethral junction so that neither organ sags or leaks. Johns Hopkins's gynecologist Howard Kelly introduced the first plication, or tucking, operation for women in 1914. This colporrhaphy, surgical repair of the vagina, secured the area of the bladder neck with stitches on either side of the urethra. In 1949, a group of specialists, led by urologist Victor F. Marshall, produced the Marshall-Marchetti-Krantz (MMK) procedure, a retropubic suspension of the bladder neck that used an incision in the lower abdomen. Through the incision, urologists stitched the tissue surrounding the bladder neck to the bone or supporting structures. Both the MMK procedure and J.E. Burch's 1961 minimally invasive variation (urethropexy) yielded easy access to immobilize the junction. Another version is the transvaginal approach to bladder suspension—pioneered in 1959 by A.J. Pereyra and since modified by other urologists, including Thomas Stamey, Shlomo Raz and R.F. Gittes. The transvaginal approach involves elevating the bladder neck with sutures placed in the abdominal or pelvic walls.

BACK       page -- 1 -- 2 -- 3 -- 4 -- 5 -- 6       NEXT
sitemap acknowledgements termsofuse privacypolicy disclaimers