Treatment of stress incontinence with the SPARC sling: intraoperative and early complications of 445 patients.
OBJECTIVE
To review our series of 445 patients to obtain safety and early outcome information regarding use of the SPARC mid-urethral sling. The SPARC mid-urethral sling is commonly used to treat stress urinary incontinence. The SPARC technique involves passage of the trocars from an initial suprapubic approach.


METHODS
We retrospectively reviewed the charts of all SPARC slings performed from the first procedure in August 2001 through December 2003. The Urogenital Distress Inventory and Incontinence Impact Questionnaire short-form surveys were mailed to the patients. All SPARC procedures were performed on an outpatient basis unless the patient was undergoing a concurrent procedure.


RESULTS
The average patient age was 60 years. Concurrent prolapse repair and/or hysterectomy were performed in 97 patients (22%). The mean time from surgery to questionnaire response was 15 months. Ninety-one percent would undergo the procedure again, and 84% would recommend the SPARC to a friend. One patient was admitted postoperatively for a rectus hematoma. Another presented after 3 days with abdominal pain resulting from a small bowel perforation. Sling release was performed in 19 patients (4.3%) because of large postvoid residual urine volume or obstructive voiding symptoms.


CONCLUSIONS
The SPARC mid-urethral sling is an effective outpatient surgical procedure to treat stress urinary incontinence.
Hodroff
Marc A
MA
Center for Continence Care, Metropolitan Urologic Specialists, St. Paul, Minnesota, USA. marchodroff@yahoo.com
Sutherland
Suzette E
SE
Kesha
Jyothi B
JB
Siegel
Steven W
SW
D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D019736:Prostheses and Implants / Q000009:adverse effects*; D012189:Retrospective Studies; D013526:Surgical Mesh / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D014521:Urethra; D014550:Urinary Incontinence, Stress / Q000601:surgery*