[Burch vs. Stamey comparison. Long-term outcome of 2 competing surgical methods]

Stress incontinence is the most frequent form of incontinence found in females. The usual method of surgery for this is to lift the bladder neck towards cranial and ventral. Two competitive techniques--bladder neck suspension in accordance with Stamey and colposuspension in accordance with Burch--were retrospectively investigated. A total of 95 women underwent surgery and it was possible to evaluate the postoperative course in 46 and 30 (total 76) patients respectively. Initially, both surgical techniques demonstrated a very good success rate (91.3% and 96.7% resp.). However, the continence rate of the Stamey patients deteriorated after 6 weeks down to 78.3% and after more than 2 years only 28.6% of these patients were still completely continent (mean follow-up 40.4 mths), whereas deterioration in the Burch patients was only 87% (mean follow-up 44.25 mths). The disappointing results with the Stamey technique did not correlate with the degree of initial continence. It was noted here that obese patients showed a greater tendency towards regression. The three cases of recurring incontinence after Burch colposuspension were already relapses at the time of surgery. With respect to long-term follow-up, our results with the Stamey method were distinctly poorer than with the Burch technique: Therefore, in our opinion, the Burch colposuspension procedure and fascioplasty should be the method of choice for the management of stress incontinence.