The use of prophylactic stamey bladder neck suspension to prevent post-operative stress urinary incontinence in clinically continent women undergoinggenitourinary prolapse repair

The present study was undertaken to evaluate the efficacy of Stamey bladder neck suspension in preventing post-perative stress urinary incontinence in clinically continent women undergoing surgery for genitourinary prolapse. Thirty clinically continent women with seven genitourinary prolapse were fo und to have a positive stress test with re-positioning of the prolapse. The y all had significant urethrovesical junction hypermobility. In addition to the genitourinary prolapse repair, these patients underwent a prophylactic Stamey procedure to prevent the possible development of post-operative str ess urinary incontinence. The mean duration of follow-up was 8 +/- 4.5 mont hs (range, 3-19 months). Seven (23.30%) patients developed overt post-opera tive stress urinary incontinence that was confirmed urodynamically. Eleven (36.7%) other patients denied stress incontinence; however, postoperative u rodynamics demonstrated sphincteric incontinence. Post-operative complicati ons were uncommon and minor. In conclusion, continent patients with a posit ive stress test demonstrated on re-positioning of the prolapse during pre-o perative urodynamic evaluation are considered to he at high risk of develop ing post-operative stress urinary incontinence. In these patients, an addit ional, effective anti-incontinence procedure should be considered during su rgical correction of genitourinary prolapse. The Stamey procedure, although simple and safe, does not appeal to be the optimal solution to this clinic al problem. (C) 2000 Wiley-Liss, Inc.