Table of Contents
ISRN Urology
Volume 2012, Article ID 109858, 8 pages
Clinical Study

Outcome Assessment of the Marshall Coughing Test during Cervix Reposition Maneuver in Women with Urinary Stress Incontinence with/without Genital Prolapse

Department for Urogynaecology and Pelvic Floor Disorders, University Clinic for Gynaecology and Obstetrics, Medical Faculty, University “Saint Cyril and Methodius”, Vodnjanska 17, 1000 Skopje, Macedonia

Received 22 November 2011; Accepted 11 December 2011

Academic Editors: C. E. Constantinou and M. Salido

Copyright © 2012 Vesna Antovska. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. Outcome assessment of the Marshall coughing test (MT) during cervix reposition maneuver (CRM) in women with urinary stress incontinence (USI) with/without genital prolapse (GP). Study Design. 268 patients, divided into USIg ( 𝑛 = 1 3 2 ) with isolated USI and USIGPg ( 𝑛 = 1 3 6 ) with USI and GP stage I/II, additionally divided into USIGP(A) ( 𝑛 = 7 8 ) with USI and GP stage I and USIGP(B) ( 𝑛 = 5 8 ) with USI and GP stage II, were evaluated with pelvic organ prolapse quantification (POPQ), MT, and CRM. Results. (a) 7.58% had (+) MT with CRM in USIg; (b) in up to 96.15% MT became negative during CRM in USIGP(A); (c) in 51.72% MT became positive only during CRM, as a sign for occult USI in USIGP(B); (d) point Aa (POPQ), which is bladder neck(BN) projection on the anterior vaginal wall, was situated higher in rest position (RP), but moved lower during the Valsalva maneuver (VM) in USIg versus USIGPg ( 𝑃 < 0 . 0 5 ). Conclusion. CRM could be useful arm in selection of (1) patients with isolated USI and great chance for postoperative failure; (2) patients with USI+GP stage I, who need GP repair during antistress surgery; (3) patients with USI + GP stage II, who need antistress procedure during vaginal hysterectomy.