Objective To evaluate the outcome of a new modification of percutaneous needle suspension, using a bone anchor system for fixing the suture at the pubic bone, and to compare the results with those published previously. Patients and methods From March 1996, 37 patients with stress urinary incontinence (>2 years) were treated using a bone anchor system. On each side the suture was attached to the pubocervical fascia and the vaginal wall via a broad ‘Z’‐stitch. A urodynamic investigation performed preoperatively in all patients confirmed stress incontinence and excluded detrusor instability. The outcome was assessed either by a clinical follow‐up investigation or using a standardized questionnaire, over a mean follow‐up of 11 months (range 6–18). Results In the 37 patients, the procedure was successful in 25 (68%), with 16 (43%) of the patients completely dry and nine (24%) significantly improved. Removal of the bone anchor and suture was necessary in two patients, because of unilateral bacterial infection in one and a bilateral soft tissue granuloma in the other. One bone anchor became dislocated in a third patient. In two cases where the treatment failed, new detrusor instability was documented urodynamically. Minor complications were prolonged wound pain in 10 (26%) and transient urinary retention or residual urine in 12 patients (32%). Conclusion The poor success rate in this study corresponds with the long‐term results of conventional or modified needle suspension procedures and does not reinforce the optimistic results of bone anchoring published recently. Because of the poorer long‐term results from percutaneous needle suspension than from other techniques of open retropubic bladder neck suspension, it remains questionable whether percutaneous needle suspension should be considered a first‐line procedure for the treatment of female stress urinary incontinence.
Objectives To evaluate the long-term continence rate, frequency of complications other than urinary retention was significant during and after surgery, at 27%, including subjective satisfaction and therapyassociated morbidity, of patients undergoing Stamey and in accord with the complication rate reported in earlier studies. bladder neck suspension. Patients and methods Eighty-five women (median ageConclusions Compared with other bladder neck suspension procedures, e.g. Burch colposuspension, the 55 years, range 30-85) with urinary stress incontinence treated by Stamey bladder neck suspension at Stamey procedure appears to be associated with a higher frequency of postoperative recurrent urinary our institution between 1987 and 1995 were evaluated using an anonymous questionnaire over a mean stress incontinence. Therefore, the Stamey procedure should only be used if the patient demands a minimally (range) follow-up of 61 (13-93) months. Results Of the 85 patients, 44 (52%) reported an invasive surgical procedure for bladder neck suspension. Although #60% of patients were satisfied with improvement in clinical symptoms at the evaluation and 29 (34%) were completely continent after the the durable improvement in clinical symptoms, it is appropriate to inform patients before surgery of the Stamey procedure. However, 53 (62%) patients reported subjective satisfaction with the result, because high recurrence rate after Stamey bladder neck suspension. they had a durable improvement in continence for a mean (range) of 44 (10-79) months. There was noKeywords Stamey bladder neck suspension, questionnaire-based analysis, long-term continence, compli-correlation between the number of previous urogynaecological operations undergone by the patients and cations, subjective satisfaction the success of the Stamey procedure. However, the like colporrhaphy or pubococcygeal plasty are associated
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