Gofrit O N, Landau E H, Shapiro A, Pode D
Department of Urology, Hadassah Medical Center, Hebrew University, Jerusalem, Israel.
Eur Urol. 1998 Oct;34(4):339-43. doi: 10.1159/000019751.
To assess the long-term results of the Stamey vesicourethral suspension for stress urinary incontinence.
A total of 72 case records of women who underwent the Stamey procedure in the years 1985-1991 was reviewed. Every patient had a full preoperative evaluation including filling cystometry, urethral pressure profilometry and imaging of the kidneys and bladder. The long-term subjective results were determined by a telephone interview with the patients, utilizing a standard questionnaire. A successful result was defined as no need for pads under any circumstances. Every patient who reported on persistent or recurrent incontinence was requested to return for reevaluation in the urology clinic.
The long-term success rate of the Stamey procedure in 63 evaluable patients was 69.8% (mean follow-up: 90 months). In 19 women, the operation had failed. About 80% of the failures were evident within 2 years after surgery. The long-term success rate of surgery in 28 women with pure stress incontinence was 93%. When mild irritative symptoms were present before surgery (29 patients) the subjective success rate was 65.5%, and in 6 patients with severe urge symptoms the success rate was only 33%. The difference between these groups was highly significant (p = 0.003). No correlation was found between the age of the patient at surgery, the number of children delivered by the patient, the grade of stress incontinence, the duration of symptoms before surgery or a history of a previous operation for stress incontinence and the success rate of the operation.
The Stamey vesicourethral suspension is characterized by a relatively high and long-standing success rate. This procedure has an important place in the treatment of women with urinary stress incontinence.
评估Stamey膀胱尿道悬吊术治疗压力性尿失禁的长期效果。
回顾了1985年至1991年间接受Stamey手术的72例女性患者的病历。每位患者术前均进行了全面评估，包括膀胱充盈测压、尿道压力测定以及肾脏和膀胱成像。通过电话采访患者，使用标准问卷确定长期主观结果。成功的定义为在任何情况下都无需使用尿垫。每例报告持续性或复发性尿失禁的患者均被要求返回泌尿外科门诊进行重新评估。
63例可评估患者中，Stamey手术的长期成功率为69.8%（平均随访90个月）。19例女性手术失败。约80%的失败在术后2年内明显。28例单纯压力性尿失禁女性患者手术的长期成功率为93%。术前存在轻度刺激性症状的患者（29例）主观成功率为65.5%，6例有严重尿急症状的患者成功率仅为33%。这些组间差异具有高度统计学意义（p = 0.003）。未发现患者手术时的年龄、生育子女数、压力性尿失禁程度、术前症状持续时间或既往压力性尿失禁手术史与手术成功率之间存在相关性。
Stamey膀胱尿道悬吊术的特点是成功率相对较高且持久。该手术在治疗女性压力性尿失禁方面具有重要地位。
