Needle Suspension of the Bladder Neck for Stress Urinary Incontinence

Abstract

We have investigated surgical results of quantitative suspension of the bladder neck for stress urinary incontinence. Three hundred ninety-four female patients suffering from stress incontinence have been operated on with Stamey's or Gittes' procedures during the past 8 years. While the bladder neck was elevated by quantifying tension of nylon threads in 84 patients, 310 patients subsequently were operated on by quantifying both tension and length of nylon loops. A follow-up period averaged 51 months for a group of the Stamey's and 19 months for a group of Gittes' procedures. Postoperative continence rate was defined by patients' subjective evaluation. Those whose nylon loops were quantified as from 130 to 149 mm attained the highest continence rate, which was not related to age or severity of incontinence. Postoperative difficulty in urination was less in those who had nylon loops of 130 to 149 mm, and was more in those over 60 years of age. Eighty-eight percent of the patients stated very much satisfied or satisfied with the surgery they had undergone. Continence rate was 78% for those operated on with the Stamey's (51 months later) and 69% with the Gittes' procedures (19 months later). The 7-year continence rate was 77% for the former and the 3-year continence rate was 38% for the latter, indicating that the Stamey's procedure was significantly more useful than the Gittes' procedure. Postoperative complications were encountered with 17% of the patients. We conclude that quantitative suspension of the bladder neck is of value to obtain the high success rate of the needle suspension procedure.

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