SHOULD STAMEY COLPOSUSPENSION BE OUR PRIMARY SURGERY FOR STRESS-INCONTINENCE

Objective To evaluate the outcome of the Stamey procedure for stress i ncontinence and to decide if it is an acceptable first-line option for the treatment of patients. Patients and methods Between June 1987 and March 1993 67 women had Stamey bladder neck suspension carried out fo r 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% wer e much improved. At 6 months 56% of patients were dry and 21% were muc h improved. More than 1 year following surgery, of 58 patients respond ing only 31% were dry and 28% were much improved. More than 5 years af ter surgery only 18% of the 28 women responding were dry. The factors which were significantly associated with failure were obesity (P < 0.0 05) and the number of pads used per day (P < 0.05). Previous surgery m ay also be an important factor. Conclusion The Stamey vesical neck sus pension has a good early success rate but the results in the longer te rm are not acceptable. This operation should not be used as a first-li ne treatment for stress incontinence and should be reserved for specif ic patient subgroups.