THE STAMEY AND GITTES PROCEDURES - LONG-TERM FOLLOW-UP IN RELATION TOINCONTINENCE TYPES AND PATIENT AGE

Purpose: We report the long-term results of needle suspension of the b ladder neck for stress incontinence. Materials and Methods: A total of 382 patients with stress incontinence underwent either the Stamey (gr oup 1, 342 women) or Gittes procedure (group 2, 40) in a nonrandomized trial. Surgical outcomes and patient satisfaction were assessed by qu estionnaires. Surgical outcomes were then analyzed in relation to surg ical procedures, McGuire incontinence types and patient age. Followup averaged 8.1 years for group 1 and 5.0 years for group 2. Results: Kap lan-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 con tinence 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 h ad an 11-year cumulative continence rate of 61.4%, which was not stati stically different from the younger women (68.9% at 14 years). Of the patients 79% were extremely satisfied or satisfied with surgical resul ts, and urge incontinence developed de novo in 12% of the patients. Co nclusions: We conclude that the Stamey is superior to the Gittes opera tion, needle bladder neck suspension is as effective in older as in yo unger adults and women with type III incontinence should not undergo e ither operation.