Should Stamey colposuspension be our primary surgery for stress incontinence?
OBJECTIVE
To evaluate the outcome of the Stamey procedure for stress incontinence and to decide if it is an acceptable first-line option for the treatment of patients.


METHODS
Between June 1987 and March 1993 67 women had Stamey bladder neck suspension carried out for the treatment of stress incontinence. In September 1993 all patients received a detailed questionnaire to ascertain their present status.


RESULTS
Immediately after surgery 70% of patients were dry and 15% were much improved. At 6 months 56% of patients were dry and 21% were much improved. More than 1 year following surgery, of 58 patients responding only 31% were dry and 28% were much improved. More than 5 years after surgery only 18% of the 28 women responding were dry. The factors which were significantly associated with failure were obesity (P < 0.005) and the number of pads used per day (P < 0.05). Previous surgery may also be an important factor.


CONCLUSIONS
The Stamey vesical neck suspension has a good early success rate but the results in the longer term are not acceptable. This operation should not be used as a first-line treatment for stress incontinence and should be reserved for specific patient subgroups.
O'Sullivan
D C
DC
Department of Urology, Derbyshire Royal Infirmary, Derby, UK.
Chilton
C P
CP
Munson
K W
KW
D000328:Adult; D000368:Aged; D001835:Body Weight; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014572:Urology / Q000379:methods