Nigam A K, Otite U, Badenoch D F
Department of Urology, St. Bartholomew's Hospital, London, UK.
Eur Urol. 2000 Dec;38(6):677-80. doi: 10.1159/000020361.
To evaluate the long-term results of Stamey's and Gittes' procedures for genuine stress incontinence.
72 needle procedures (34 Stamey; 38 Gittes) performed by a single surgeon between 1988 and 1994 were retrospectively reviewed. All patients had genuine stress incontinence on preoperative video-urodynamics. Review was at 3 months and thereafter clinically determined. Update information was gained by a patient satisfaction questionnaire.
Data were available for 9 years for the Stamey group (mean 8.4 years) and 6 years for the Gittes' (mean 5.3 years). At 3 months, 93% were dry. There was a gradual attrition with 38% of the Stamey and 14% of the Gittes patients remaining dry or improved at 5 years. At 9 years, only 28% of the Stamey patients maintained their improvement. 26% of the original cohort underwent a second procedure. All patients who had repeat needle operations have failed. 48 questionnaires (67%) were returned. Only 25% of patients expressed satisfaction with their operation.
Early success rates with endoscopic bladder neck suspension are replaced by long-term failures. The durability is poor with an ongoing recurrent incontinence rate. Repeat procedures are not worthwhile. Gittes' procedure appears to have an earlier failure rate compared to Stamey's operation.
评估用于真性压力性尿失禁的斯塔梅（Stamey）手术和吉茨（Gittes）手术的长期效果。
回顾性分析了1988年至1994年间由一名外科医生实施的72例针刺手术（34例斯塔梅手术；38例吉茨手术）。所有患者术前经视频尿动力学检查确诊为真性压力性尿失禁。术后3个月及之后进行临床评估。通过患者满意度调查问卷获取最新信息。
斯塔梅组有9年的数据（平均8.4年），吉茨组有6年的数据（平均5.3年）。术后3个月时，93%的患者无尿失禁。随着时间推移，斯塔梅组38%的患者和吉茨组14%的患者在5年时仍保持无尿失禁或病情改善。9年时，斯塔梅组仅有28%的患者维持改善状态。26%的原始队列患者接受了二次手术。所有接受重复针刺手术的患者均失败。共返回48份问卷（67%）。只有25%的患者对手术表示满意。
内镜下膀胱颈悬吊术早期成功率之后被长期失败率所取代。其耐久性较差，尿失禁复发率持续存在。重复手术不值得。与斯塔梅手术相比，吉茨手术的失败率似乎出现得更早。
