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Abstract
The aim of this work is to evaluate and compare the effectiveness and results of Stamey procedure (bladder neck suspension with cystoscopic control, dacron buttress) and tension free vaginal tape (T.V.T) in controlling stress urinary incontinence. The comparison is randomized and short term as we will follow the patients for one year.
Surgery is indicated in motivated patients with significant loss of e urine creating a social or hygienic problem. There is no contraindication for surgery (Age, prior pelvic surgery, and previously failed antiiincontinence surgery. In c.rder to be &ole to treat mcst cf the women that need surgical intervention, we have to gain experience of several different techniques. Burch colposuspension for uncomplicated primary cases, sling procedures in recurrent and low pressure urethra cases, needle suspension techniques in elderly patients.
In this study 20 patients all with GSI diagnosed according to medical history including SEAPI subjective score,
physical examination including SEAPI objective score and urodynamic study. Patients were classified into 2 groups
each containes ten patients:-
• The first group (10) patients: were treated by Stamey procedure.
• The second group (10) patients: were treated by T.V.T procedure.
The results of Stamey’s procedure group were:
1. The operative time was 60 minutes (range 40 - 80).
2. Hospital stay was 3 days (range 2-7) days.
3. seven patients (70%) were cured, two patients (20 %) were improved and in one patient (10 %) the procedure failed.
4. As regard complication: In one patient bladder perforation occurred which simply required repositioning of the prolene suture and catheterization for ten days. One patient suffered from urinary retention 48 hours after surgery and she required 2-3 weeks on catheter drainage· to achieve full voiding efficiency. Other complication are of no significant importance such as infection. One patient suffered from urgency and frequency 3 months post operatively (denovo detrosur instability).