Endoscopic bladder neck suspension revisited: Long-term results of Stamey and Gittes procedures

Objective: To evaluate the long-term results of Stamey's and Gittes' proced ures for genuine stress incontinence. Methods: 72 needle procedures (34 Stamey; 38 Gittes) performed by a single surgeon between 1988 and 1994 were retrospectively reviewed. All patients h ad genuine stress incontinence on preoperative video-urodynamics. Review wa s at 3 months and thereafter clinically determined. Update information was gained by a patient satisfaction questionnaire. Results: Data were available for 9 years for the Stamey group (mean 8.4 yea rs) and 6 years for the Gittes' (mean 5.3 years). At 3 months, 93% were dry . There was a gradual attrition with 38% of the Stamey and 14% of the Gitte s patients remaining dry or improved at 5 years. At 9 years, only 28% of th e Stamey patients maintained their improvement, 26% of the original cohort underwent a second procedure. All patients who had repeat needle operations have failed. 48 questionnaires (67%) were returned. Only 25% of patients e xpressed satisfaction with their operation. Conclusion: Early success rates with endoscopic bladder neck suspension are replaced by longterm failures. The durability is poor with an ongoing recu rrent incontinence rate, Repeat procedures are not worthwhile. Gittes' proc edure appears to have an earlier failure rate compared to Stamey's operatio n. Copyright (C) 2000 S. Karger AG, Basel.