Kondo A, Kato K, Gotoh M, Narushima M, Saito M
Department of Urology, Komaki Shimin Hospital, Japan.
J Urol. 1998 Sep;160(3 Pt 1):756-8. doi: 10.1016/S0022-5347(01)62778-2.
We report the long-term results of needle suspension of the bladder neck for stress incontinence.
A total of 382 patients with stress incontinence underwent either the Stamey (group 1, 342 women) or Gittes procedure (group 2, 40) in a nonrandomized trial. Surgical outcomes and patient satisfaction were assessed by questionnaires. Surgical outcomes were then analyzed in relation to surgical procedures, McGuire incontinence types and patient age. Followup averaged 8.1 years for group 1 and 5.0 years for group 2.
Kaplan-Meier cumulative continence rates were 71.5% for the Stamey at 14 years and 37.0% for the Gittes at 6 years postoperatively (p < 0.0001). Patients with type III incontinence attained a 10-year cumulative continence rate of 38.3%, which was significantly inferior to those with type I (76.4% at 11 years) or II (73.9% at 13 years). Older patients had an 11-year cumulative continence rate of 61.4%, which was not statistically different from the younger women (68.9% at 14 years). Of the patients 79% were extremely satisfied or satisfied with surgical results, and urge incontinence developed de novo in 12% of the patients.
We conclude that the Stamey is superior to the Gittes operation, needle bladder neck suspension is as effective in older as in younger adults and women with type III incontinence should not undergo either operation.
