Operative complications and results of the "SPARC" procedure for stress urinary incontinence [Operativne komplikacije i ishod metode SPARC u liječenju statičke inkontinencije mokraće]

Orešković, Slavko and Kalafatić, Držislav and Lovrić Gršić, Helena and Gojević, Ante and Gregov, Marija and Babić, Ivan (2009) Operative complications and results of the "SPARC" procedure for stress urinary incontinence [Operativne komplikacije i ishod metode SPARC u liječenju statičke inkontinencije mokraće]. Collegium Antropologicum, 33 (1). pp. 201-204. ISSN 0350-6134

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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.

Abstract in Croatian

U radu je prikazana učinkovitost metode SPARC i usporedba pojave komplikacija u bolesnica koje su prvi puta operirane SPARC metodom i bolesnica koje su već prethodno imale operacije dna zdjelice. Stotinu dvadeset i jedna žena sa statičkom inkontinencijom operirana je SPARC metodom zbog hipermobilnosti uretre (n=65) odnosno intrinzičnog oštećenja uretralnog sfinktera (n=56) u razdoblju između kolovoza 2002 i veljače 2007 godine. Prikazan je dugoročni ishod, operativne komplikacije (ozljeda mjehura, retropubični hematom, de novo urgencija, urinarna infekcija) te zadovoljstvo bolesnica. Ukupan udio komplikacija bio je 9,9% (12/121). Perioperativnih komplikacija bilo je 1,7%, što uključuje 2 ozljede mjehura. Zamijećena je značajna razlika u broju komplikacija između bolesnica koje su prethodno operirane odnosno onih kojima je ovo bila prva korekcija inkontinencije (9/23, 39,1% vs. 3/98, 3,1%, P<0,001). Ukupan broj postoperativnih komplikacija bio je 8,3% (10/121) uključujući 4 de novo urgencije, 4 urinarne infekcije i 2 retropubična hematoma. Nije bilo slučajeva trajne postoperativne urinarne retencije niti otežanog mokrenja. Ukupna učinkovitost metode bila je 86,8% (105/121). U bolesnica s čistom statičkom inkontinencijom, a bez prethodne operativne korekcije, SPARC je sigurna metoda, s niskim udjelom komplikacija i zadovoljavajućim dugoročnim ishodom.

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