Conrad S, Pieper A, De la Maza S F, Busch R, Huland H
Department of Urology, Eppendorf University Hospital, University of Hamburg School of Medicine, Germany.
J Urol. 1997 May;157(5):1672-7.
Reported success rates of the Stamey bladder neck suspension procedure vary from 39 to 91%. The disparity is substantially influenced by the methods used to assess the surgical outcome, with best results being found consistently in retrospective chart review studies. We assessed the true long-term outcome of the Stamey bladder neck suspension with a patient questionnaire based outcome analysis using strict definitions for cure and recurrence.
Of 172 consecutive patients 138 (80.2%) returned a questionnaire designed to assess the outcome of the procedure and the subjective satisfaction with the operative result. To our knowledge we report the longest mean followup for this procedure (66 months).
Of 130 evaluable patients with hypermobility or intrinsic sphincter deficiency leading to urinary stress incontinence 65 (50.0%) remained completely continent, 15 (11.5%) never became continent and 50 (38.5%) had recurrence 6 to 90 months after initial operative success. However, approximately two-thirds of the patients believed they were cured or substantially improved more than 5 years postoperatively.
Despite the considerable failure rate, the substantial improvement in the quality of life of almost two-thirds of the patients during long-term followup and the lack of superior techniques qualify the Stamey bladder neck suspension as a treatment of choice for urinary stress incontinence in women. We strongly emphasize the need for standardized questionnaire based outcome analyses for the evaluation of incontinence surgery.
报道的斯坦梅膀胱颈悬吊术成功率在39%至91%之间。这种差异很大程度上受评估手术结果所用方法的影响，回顾性病历审查研究中始终能发现最佳结果。我们通过基于患者问卷的结果分析，采用严格的治愈和复发定义，评估了斯坦梅膀胱颈悬吊术的真正长期结果。
在172例连续患者中，138例（80.2%）回复了一份旨在评估手术结果及对手术效果主观满意度的问卷。据我们所知，我们报告了该手术最长的平均随访时间（66个月）。
在130例因膀胱颈活动过度或固有括约肌缺陷导致压力性尿失禁的可评估患者中，65例（50.0%）保持完全控尿，15例（11.5%）从未实现控尿，50例（38.5%）在初次手术成功后6至90个月复发。然而，约三分之二的患者认为术后5年以上他们已治愈或有显著改善。
尽管失败率较高，但近三分之二患者在长期随访中生活质量有显著改善，且缺乏更优技术，这使斯坦梅膀胱颈悬吊术成为女性压力性尿失禁的一种治疗选择。我们强烈强调，对于尿失禁手术的评估，需要基于标准化问卷的结果分析。
