The Stamy procedure: a retrospective analysis of clinical outcome in stress incontinence.

OBJECTIVE: To review the clinical outcome of treatment by the modified Stamy procedure in 26 patients with genuine stress incontinence. DESIGN: A retrospective study of women with stress incontinence who underwent a modified Stamy procedure over a 2-year period between January 1991 and January 1993, of postoperative complications and the success rate three months after surgery. SUBJECTS: Twenty-six women presenting with symptomatic stress incontinence. INTERVENTIONS: All patients underwent a modified Stamy procedure. They were reviewed in the gynaecology clinic after three months. MAIN OUTCOME MEASURES: All patients were assessed by clinical examination for postoperative complications, subsequent voiding difficulties, and for recurrence or persistence of incontinence. RESULTS: The most common complications were retention of urine (23%), infection (19%), postoperative persistent pain (12%), urge incontinence (8%) and primary haemorrhage requiring transfusion (4%). The stress incontinence was subjectively cured in 81% and objectively cured in 72% when examined at three months postoperatively. CONCLUSIONS: Modified Stamy procedure is a useful operation for women with stress incontinence and it is associated with a low incidence of postoperative complications.

A retrospective evaluation of early carcinoma of the cervix treated surgically in a Provincial General Hospital.

OBJECTIVE: To assess the safety of Wertheim-Meigs hysterectomy for stage I and IIA carcinoma of the cervix performed at a Provincial General Hospital in Sri Lanka. DESIGN: A retrospective analysis of 16 cases managed from January 1992 to March 1993. SETTING: Provincial General Hospital in Sri Lanka. PATIENTS AND METHODS: Patients with either stage I or IIA carcinoma of the cervix were subjected to Wertheim-Meigs hysterectomy. All patients opted for surgery over radiotherapy when given the choice. Complications within the first 60 days were retrospectively analysed. RESULTS: Immediate operative mortality was nil, although two patients had massive haemorrhage during surgery. Injury to the pelvic colon occurred in one patient. Post-operative pyrexia (n = 16), persistent oozing from suction drains (n = 4), prolonged ileus (n = 6) and bladder dysfunction (n = 4) were the immediate post-operative complications. Average post-operative stay in the hospital was 12 days. CONCLUSIONS: Early carcinoma of the cervix treated by Wertheim-Meigs hysterectomy carries a low incidence of immediate post-operative mortality and morbidity when performed with the resources available at a Provincial General Hospital.