Clinical Trial of SPARC Procedure in Female Stress Urinary Incontinence

Jang, Hoon; Lee, Choong Bum; Cho, Dae Haeng

Abstract

PURPOSE: A suprapubic approach to the suburethral polypropylene (SPARC) procedure was reported as a new technique for urethral support in the treatment of stress urinary incontinence in women. The safety and efficacy of the SPARC procedure were evaluated in women with stress urinary incontinence.
MATERIALS AND METHODS
50 women (mean age 48.6) with stress urinary incontinence underwent the SPARC procedure under general anesthesia between October 2002 and May 2004. The preoperative evaluations included: the patients history, a physical examination, urinalysis, an urodynamic test and incontinence staging for the Stamey grade. 2 and 5 women had previously experienced failed anti-incontinence surgery and pelvic surgery, respectively. The mean follow-up period was 8.01 months, with all patients assessed for the procedural outcome, subjective satisfaction and complications.
RESULTS
The mean follow-up period, hospital stay and operation time were 8.01 months (3-15), 3.7 days (2-6) and 23 minutes (18-45), respectively. The success rate was 94%. There were no significant perioperative and postoperative complications. 3 patients (6%) had bladder perforation during the operation that necessitated an indwelling Foley catheter (mean period 7.3 days). 3 patients (6%) each had postoperative cystitis and immediate voiding difficulty that necessitated an indwelling Foley catheter (mean period 3.0 days) and bladder training, but without cutting or releasing of the tapes. 7 patients (14%) had postoperative de novo urge symptoms.
CONCLUSIONS
The SPARC procedure is a simple, safe and effective treatment for female stress urinary incontinence in terms of the short operation time and hospital day, and low complication and relatively high success rates. However, a longer follow-up will be necessary to determine its long term effect and efficacy.