Raz bladder neck suspension in women younger than sixty-five years compared with elderly women: three years' experience.

OBJECTIVE

To verify the efficacy of Raz bladder neck suspension in producing cure of genuine stress incontinence (GSI) in women younger than sixty-five years compared with elderly women, and to find out whether or not elderly patients are more prone to failure with this technique.

METHOD

We reviewed our results with this procedure in 67 women younger than sixty-five years (group I) compared with 21 elderly women (group II). Seventeen patients in group I and 4 patients in group II had bladder neck suspension for grade I-II incontinence, and 50 patients in group I and 17 in group II had additional cystocele repair by the four-corner technique. Rectocele repair and vaginal hysterectomy were also performed when indicated.

RESULTS

With a mean follow-up period of 18.2 months for group I and 16.8 months for group II, 57 women (85.1%) in group I were completely cured of stress incontinence, 6 (8.9%) had marked improvement, and 4 (6.0%) had recurrence, while in group II, 19 (90.4%) were completely cured, 1 (4.8%) had marked improvement, and 1 (4.8%) had recurrence. Namely, in group I, 94 percent of the patients were either cured or improved, as compared with 95.2 percent in group II (P = 0.6; Fisher's exact test). Postoperative complications were few, and there was no permanent urinary retention.

CONCLUSION

We conclude that, in a relatively short-term follow-up, Raz bladder neck suspension is equally successful in curing stress urinary incontinence in young and elderly females.