Surgical treatment of female stress urinary incontinence

Twenty-nine female patients were diagnosed as stress urinary incontinence (SUI) and treated with different surgical procedures from March 1982 to December 1987. One patient was operated on twice. The surgical procedures included the Marshall-Marchetti-Krantz(M-M-K) operation in 2 cases, Burch's operation in 2 cases, revised Pereyra's needle suspension in 9 cases and the modified Pereyra-Stamey's operation in 17 cases. Two of the 29 cases were lost to follow-up. The mean duration of follow-up after operation was 44 months. Five patients responded poorly to treatment. The other 22 cases are in good and continent condition. The success rate of the four different procedures were, M-M-K operation 50%(1/2), Burch's operation 100%(2/2), revised Pereyra's needle suspension 66.7%(6/9), and modified Pereyra-Stamey's operation 94.1%(16/17), respectively. Since the application of the Pereyra's needle in SUI, the Marshall-Marchetti-Krantz and Burch's operations have been performed rarely because of their complexity and the entrance into the abdomen. On the contrary, the revised Pereyra's needle suspension and Stamey's procedure became gradually popular. We started with the revised Pereyra's needle suspension for SUI in 1982, and experienced a high failure rate with this procedure. Thus, we modified the procedure using dacron bolsters like Stamey to take over the helical suture in the bladder neck. We conclude that a modified Pereyra-Stamey's procedure is a simple operation with a high success rate.