Burch against Stamey. Comparison of two competing operative procedure

Abstract

Stress incontinence is the most frequent form of incontinence found in females. The usual method of surgery for this is to lift the bladder neck towards cranial and ventral. Two competitive techniques--bladder neck suspension in accordance with Stamey and colposuspension in accordance with Burch--were retrospectively investigated. A total of 95 women underwent surgery and it was possible to evaluate the postoperative course in 46 and 30 (total 76) patients respectively. Initially, both surgical techniques demonstrated a very good success rate (91.3% and 96.7% resp.). However, the continence rate of the Stamey patients deteriorated after 6 weeks down to 78.3% and after more than 2 years only 28.6% of these patients were still completely continent (mean follow-up 40.4 mths), whereas deterioration in the Burch patients was only 87% (mean follow-up 44.25 mths). The disappointing results with the Stamey technique did not correlate with the degree of initial continence. It was noted here that obese patients showed a greater tendency towards regression. The three cases of recurring incontinence after Burch colposuspension were already relapses at the time of surgery. With respect to long-term follow-up, our results with the Stamey method were distinctly poorer than with the Burch technique: Therefore, in our opinion, the Burch colposuspension procedure and fascioplasty should be the method of choice for the management of stress incontinence.

A questionnaire‐based outcome analysis of the Stamey bladder neck suspension procedure for the treatment of urinary stress incontinence: the Hannover experience

“…In contrast to the initial continence rate of >90% in studies with a follow‐up of <2 years [ 3, 8, 9, 20, 22], several subsequent investigations reported highly variable success rates of 30–80% after the Stamey procedure [ 5, 7, 12, 17, 19, 23, 27]. From these divergent results and the observation that incontinence recurred even >7 years after bladder neck suspension, it was suggested that the long‐term success rates reported for the procedure in several earlier studies might depend on the duration of the follow‐up, diverging criteria for the selection of patients and the experience of the surgeon.…”

Langzeitergebnisse der Blasenhalssuspension nach Stamey — Pereyra in der Behandlung der weiblichen Stressharninkontinez

“…Im Gegensatz zur initial berichteten postoperativen Kontinenzrate von > 90 % in solchen Serien, denen eine Nachbeobachtungszeit von < 2 Jahren zugrunde lag [2,10,11,29,32], wurden im Gefolge sehr unterschiedliche, zwischen 30 % und 80 % variierende Erfolgsraten beobachtet [5,6,9,13,14,23,26]. Unter Berücksichtigung dieser Ergebnisse und der Beobachtung der sich in Einzelfällen auch nach sehr langen Zeiträumen (> 7 Jahre) noch einstellenden Inkontinenzrezidive wurde vermutet, dass verschiedene Faktoren, wie bei-spielsweise die Länge der verschiedenen Studien zugrunde liegenden Nachbeobachtungszeit, die Patientenselektion und die Erfahrung der Operateure das Langzeitergebnis in entscheidendem Maûe zu beeinflussen vermögen.…”