The Comparison of Long Term Outcome after Burch and Stamey Operation in Stress Urinary Incontinence Patients / 대한비뇨기과학회지

Burch and Stamey operations are reliable techniques for correcting genuine stress urinary - incontinence. The purpose of this study is to evaluate which operation brings better success and which factors affect the postoperative outcome. We reviewed 103 patients who underwent Burch (53 patients) and Stamey (50 patients) operations between January 1992 and June 1994 for stress urinary incontinence. The followup period of all patients was over 2 years and mean followup was 37 months. A standardized questionnaire using telephone was used to evaluate postoperative outcome. Cure (complete dryness) rate was 72% in Burch and 48% in Stamey group. Overall, a successful outcome (cure or rare stress incontinence not requiring protection) was 92% of patients in Burch and 76% in Stamey group. In Stamey group, the only significant predictor of outcome was the degree of preoperative stress urinary incontinence (mild, moderate, severe) but not in Burch group. No statistical correlation in success was found with patients age, number of parity, prior hysterectomy, combined operation (hysterectomy, anterior and posterior colporraphy), preoperative urgency and urge incontinence. Preoperative urgency was present in 23% of Burch, and 30% of Stamey group patients. Postoperative resolution of urgency was 58% in Burch, and 60% in Stamey group. De novo urgency occurred in 20% of Burch group patients, and in 14% of Stamey group patients. Persistent or de novo urgency was more common among failure group than success group (75% vs 20% in Burch group, 42% vs 16% in Stamey group). The success rate of Burch operation was higher than Stamey operation. So we think Burch operation is better management for stress urinary incontinence. In Stamey group, the only factor affecting on outcome was the degree of preoperative stress urinary incontinence.

A Comparison of Stamey with Raz Operation for the Treatment of Stress Urinary Incontinence / 대한비뇨기과학회지

To compare the efficacy of Stamey with that of Raz procedure in the correction of stress urinary incontinence, we studied retrospectively 43 patients who underwent either procedure at our institution between January, 1989 and June, 1994. Of 43 Patients were 23 underwent Stamey and 20 underwent Raz procedures. Patient's characteristics of the 2 groups were similar, but mean operative time was 107 minutes in Stamey and 76 minutes in Raz procedure(P<0.05), a care rate was obtained postoperatively in 65y. of the patient in Stamey and in 85% in Raz procedure(P<0.05). Postoperative complications were similar in 13.5% of the patients in Stamey and in 12.5% in Raz procedure. Although most predictive factors were not associated with cure or failure in our series, the postoperative cure rate was significantly higher in the group with urinary retention of more than a week. It is thought that Raz procedure is more safe and accurate than Stamey procedure by its shorter operation time and higher success rate(P<0.05). although patient's satisfaction with postoperative morbidity is similar between Stamey and Raz procedure.