Repozitorij Medicinskog fakulteta Sveučilišta u Zagrebu

Operative complications and results of the "SPARC" procedure for stress urinary incontinence

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. Collegium antropologicum, 33 (1). pp. 201-204. ISSN 0350-6134

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    Croatian abstract

    OPERATIVNE KOMPLIKACIJE I ISHOD METODE SPARC U LIJEČENJU STATIČKE INKONTINENCIJE MOKRAĆE ----- 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.

    English 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.

    Item Type: Article
    MeSH: Adult ; Cohort Studies ; Female ; Humans ; Middle Aged ; Postoperative Complications/etiology ; Retrospective Studies ; Urinary Incontinence, Stress/surgery ; Urologic Surgical Procedures/methods
    Divisions: Katedra za ginekologiju i opstetriciju
    Depositing User: Marijan Šember
    Status: Published
    Creators:
    CreatorsEmail
    Orešković, Slavko
    Kalafatić, Držislav
    Lovrić Gršić, Helena
    Gojević, Ante
    Gregov, Marija
    Babić, Ivan
    Date: March 2009
    Date Deposited: 31 Aug 2009
    Last Modified: 23 Sep 2011 18:11
    Subjects: /
    Related URLs:
      URI: http://medlib.mef.hr/id/eprint/641

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