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Should Stamey colposuspension be our primary surgery for stress incontinence?
D C O'Sullivan1, C P Chilton, K W Munson
1Department of Urology, Derbyshire Royal Infirmary, Derby, UK.
Objective:
To evaluate the outcome of the Stamey procedure for stress incontinence and to decide if it is an acceptable first-line option for the treatment of patients.
Patients And Methods:
Between June 1987 and March 1993 67 women had Stamey bladder neck suspension carried out for the treatment of stress incontinence. In September 1993 all patients received a detailed questionnaire to ascertain their present status.
Results:
Immediately after surgery 70% of patients were dry and 15% were much improved. At 6 months 56% of patients were dry and 21% were much improved. More than 1 year following surgery, of 58 patients responding only 31% were dry and 28% were much improved. More than 5 years after surgery only 18% of the 28 women responding were dry. The factors which were significantly associated with failure were obesity (P < 0.005) and the number of pads used per day (P < 0.05). Previous surgery may also be an important factor.
Conclusion:
The Stamey vesical neck suspension has a good early success rate but the results in the longer term are not acceptable. This operation should not be used as a first-line treatment for stress incontinence and should be reserved for specific patient subgroups.
