title: Operative complications and results of the "SPARC" procedure for stress urinary incontinence.
abstract: The aim of this study was to determine the efficacy and operative complications of the suprapubic arc (SPARC) procedure in stress incontinent women with and without previous anti-incontinence surgery. One-hundred and twenty-one patients with stress urinary incontinence (SUI) were treated with SPARC for correction of urethral hypermobility (N = 65) and intrinsic sphincter deficiency (N = 56) between August 2002 and February 2007. The long-term surgical results, operative complications (bladder injury, retropubic hematoma, de novo urgency and urinary infection) and patients' satisfaction were assessed. The overall complication rate was 9.9% (12/121). The perioperative complication rate was 1.7% including 2 urinary bladder injuries. Significant difference in the overall complications rate was detected between women with and without previous surgery (23/45, 51.1% vs. 6/108, 5.5%, chi2 = 49.89, P < 0.001). The overall postoperative complication rate was 8.3% (10/121) including 4 de novo urgencies, 4 urinary infections and 2 retropubic hematomas. There were 3 patients with postoperative urinary retention managed conservatively, without voiding difficulties on control visits. The objective cure rate after the follow-up was 86.8% (105/121). In patients with SUI and without preceding vaginal operations SPARC is a good method with low incidence of perioperative complications, promising long-term results and high patient satisfaction.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: Slavko
authors.initials: S
authors.lastname: Oresković
authors.forename: Drzislav
authors.initials: D
authors.lastname: Kalafatić
authors.forename: Helena Lovrić
authors.initials: HL
authors.lastname: Grsić
authors.forename: Ante
authors.initials: A
authors.lastname: Gojević
authors.forename: Marija
authors.initials: M
authors.lastname: Gregov
authors.forename: Ivan
authors.initials: I
authors.lastname: Babić
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*