To evaluate clearly the Marshall-Marchetti-Krantz cystourethropexy in defined populations we did a retrospective study of 151 women who underwent the procedure as a first attempt to correct stress incontinence. Of 140 patients for whom data were available 126 (90 per cent) were cured, 12 (8.6 per cent) were improved and 2 (1.4 per cent) failed. Preoperative cystoscopy was normal in 83 women (67.5 per cent). The most common abnormality was inflammatory change (82.5 per cent). Preoperative findings failed to correlate with postoperative irritative symptoms, indicating that surgical correction of documented mechanical instability is warranted. Concurrent medical problems, such as obesity and chronic obstructive pulmonary disease, were not associated with failures. Significant complications occurred in 11.4 per cent of the patients but there were no deaths. In view of a 90 to 98 per cent success rate with long-term followup (average 45.7 months) the Marshall-Marchetti-Krantz operation should be considered the procedure of choice in cases of primary stress incontinence. In addition, comparisons with other well defined groups and with modifications of the original procedure will be facilitated.

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Phytophotodermatitis commonly occurs in skin exposed to sunlight after contact with plants containing furocoumarins. While it is recognized that the consumption of plants or vegetables containing furocoumarins can potentially trigger a phytophotodermatitis, there have been no reports to date of a phytophotodermatitis triggered by an ingested herbal remedy. We describe the case of a 56-year-old farmer who developed an extensive photo-induced dermatitis after ingesting a herbal decoction prescribed for his chronic hand dermatitis.

We studied 114 women who underwent the Marshall-Marchetti-Krantz vesicourethropexy as a secondary procedure for recurrent stress incontinence. Of 99 patients for whom data were available the first operation consisted of vaginal procedures only in 57 (group 1) and suprapubic procedures somewhat related to our method of vesicourethropexy in 42 (group 2). The success rate for group 1 was 80 per cent, while it was 90 per cent for group 2. Cured and improved rates were similar (95 to 96 per cent, respectively). Significant complications occurred in 12.6 per cent of the patients. The high success rate combined with a reasonably long followup indicates that a repeat Marshall-Marchetti-Krantz vesicourethropexy certainly is warranted and can be expected to provide a good result in at least 90 per cent of the cases.