The Stamey and Gittes procedures: long-term followup in relation to incontinence types and patient age.
OBJECTIVE
We report the long-term results of needle suspension of the bladder neck for stress incontinence.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Department of Urology, Komaki Shimin Hospital, Japan.
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A
Kondo
K
K
Kato
M
M
Gotoh
M
M
Narushima
M
M
Saito
D000328:Adult; D000367:Age Factors; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods; D013997:Time Factors; D014550:Urinary Incontinence, Stress / Q000601:surgery*