A QUESTIONNAIRE-BASED OUTCOME ANALYSIS OF THE STAMEY BLADDER NECK SUSPENSION PROCEDURE FOR THE TREATMENT OF URINARY STRESS-INCONTINENCE - THE HANNOVER EXPERIENCE

Objectives To evaluate the long-term continence rate, including subjec tive satisfaction and therapy-associated morbidity, of patients underg oing Stamey bladder neck suspension. Patients and methods Eighty-five women (median age 55 years, range 30-85) with urinary stress incontine nce treated by Stamey bladder neck suspension at our institution betwe en 1987 and 1995 were evaluated using an anonymous questionnaire over a mean (range) follow-up of 61 (13-93) months. Results Of the 85 patie nts, 44 (52%) reported an improvement in clinical symptoms at the eval uation and 29 (34%) were completely continent after the Stamey procedu re. However, 53 (62%) patients reported subjective satisfaction with t he result, because they had a durable improvement in continence for a mean (range) of 44 (10-79) months, There was no correlation between th e number of previous urogynaecological operations undergone by the pat ients and the success of the Stamey procedure, However, the frequency of complications other than urinary retention was significant during a nd after surgery, at 27%, and in accord with the complication rate rep orted in earlier studies. Conclusions Compared with other bladder neck suspension procedures, e.g. Burch colposuspension, the Stamey procedu re appears to be associated with a higher frequency of postoperative r ecurrent urinary stress incontinence. Therefore, the Stamey procedure should only be used if the patient demands a minimally invasive surgic al procedure for bladder neck suspension. Although approximate to 60% of patients were satisfied with the durable improvement in clinical sy mptoms, it is appropriate to inform patients before surgery of the hig h recurrence rate after Stamey bladder neck suspension.