title: Prospective Study Comparing the Suprapubic Arc (Sparc) Procedure and the Transobturator (Monarc) Procedure for Treating Female Stress Urinary Incontinence.
abstract: OBJECTIVE
  In a comparative trial we evaluated the efficacy and safety of the suprapubic arch (Sparc) and transobturator (Monarc) procedures for the treatment of female stress urinary incontinence (SUI).
  
  
  METHODS
  Between November 2003 and May 2004, 46 women with SUI who underwent the Sparc procedure and 42 women who underwent the Monarc procedure were analyzed. The preoperative evaluation included history taking, physical examination, voiding diary, stress and 1-h pad tests and a comprehensive urodynamic examination. Postoperative evaluation included a stress test, 1-h pad test, and uroflowmetry with postvoid residuals.
  
  
  RESULTS
  After 1 year of follow up, the rates of cure and satisfaction were 93.5 and 93.0%, respectively, in the Sparc group. The rates of cure and satisfaction were 95.2 and 85.7%, respectively, in the Monarc group. After 2 years of follow up, the rates of cure (93.5 vs 92.9%) and satisfaction (84.8 vs 83.3%) were similar between the two groups. No bladder injury occurred in the Monarc group. Bladder injury occurred in 6.5% (n = 3) of the patients in the Sparc group. Vaginal wall perforation occurred in 4.8% (n = 2) of the patients in the Monarc group (P > 0.05). Late complications included de novo urge symptoms (8.7 vs 11.9%) and voiding dysfunction (10.9 vs 9.5%).
  
  
  CONCLUSIONS
  The transobturator Monarc procedure appears to be as efficient and safe as the retropubic Sparc procedure for the treatment of SUI.
authors.affiliation: Department of Urology, School of Medicine, Chungnam National University, Daejeon, South Korea.
authors.forename: Ju Hyun
authors.initials: JH
authors.lastname: Shin
authors.affiliation: Department of Urology, School of Medicine, Chungnam National University, Daejeon, South Korea.
authors.forename: Jae Sung
authors.initials: JS
authors.lastname: Lim
authors.affiliation: Department of Urology, School of Medicine, Chungnam National University, Daejeon, South Korea.
authors.forename: Ki Hak
authors.initials: KH
authors.lastname: Song
authors.affiliation: Department of Urology, School of Medicine, Chungnam National University, Daejeon, South Korea.
authors.forename: Chong Koo
authors.initials: CK
authors.lastname: Sul
authors.affiliation: Department of Urology, School of Medicine, Chungnam National University, Daejeon, South Korea.
authors.forename: Yong Gil
authors.initials: YG
authors.lastname: Na
keywords: monarc; sparc; treatment outcome; urinary stress incontinence