The Suprapubic Arch Sling Procedure for Treatment of Stress Urinary Incontinence: A 5-Year Retrospective Study

Abstract

Background: Up to now, numerous similar products concerning the surgical treatment of female stress urinary incontinence (SUI) have been developed. Objective: To assess the long-term efficacy and safety of the suprapubic arch (SPARC) sling system in women with SUI. Design, setting, and participants: This was a long-term retrospective study. All patients underwent a comprehensive pre- and postoperative evaluation. Forty-six women were available for clinical follow-up investigation after SPARC sling placement. Intervention: Eighty-six women with SUI and a positive cough test underwent SPARC sling placement between June 2001 and January 2004. Measurements: At follow-up all 46 patients underwent a cough test, a pad test, uroflowmetry, and sonographic postvoid residual volume measurement. Women rated their subjective continence status (continent, slightly incontinent, incontinent) and were asked if they would undergo the procedure again and if they would recommend it to a friend. Objective cure was defined as a pad weight 0-1 g and a negative cough test. Subjective cure was defined as no use of pads. Results and limitations: The median follow-up was 5.2 yr. The objective cure rate was 76%; the subjective cure rate was 52%. Sixty-three percent of the patients rated themselves as continent, 33% as slightly incontinent, and 4% as severely incontinent. Most of the women (98%) would recommend the SPARC procedure to a friend and would undergo the procedure again. Conclusions: The SPARC sling system is an effective and safe procedure for the treatment of female SUI. Patient satisfaction is independent of complete dryness. © 2009 European Association of Urology.