Suprapubic Arch Procedure for the Treatment of Urinary Incontinence in Elderly Female Patients

Joon Myoung Park; Ji Hyeong Yu; Luck Hee Sung; Jae Yong Chung; Choong Hee Noh

doi:10.4111/kju.2008.49.7.604

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Park, Yu, Sung, Chung, and Noh: Suprapubic Arch Procedure for the Treatment of Urinary Incontinence in Elderly Female Patients

Original Article

Korean J Urol 2008;49(7):604-608.

Published online: 19 January 2008

DOI: https://doi.org/10.4111/kju.2008.49.7.604

Suprapubic Arch Procedure for the Treatment of Urinary Incontinence in Elderly Female Patients

Joon Myoung Park, Ji Hyeong Yu, Luck Hee Sung, Jae Yong Chung, Choong Hee Noh

From the Department of Urology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea

Received 6 May 20083 June 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

There has been considerable controversy regarding the treatment of urinary incontinence (UI). The aim of our study was to investigate the efficacy and safety of the suprapubic arch (SPARC) procedure for the management of UI in elderly women.

Materials and Methods

A retrospective analysis was conducted on 301 women who underwent the SPARC procedure for SUI. The patients were divided into two groups: group A (＜65 years) and group B (≥65 years). Among these patients, women with mixed urinary incontinence (MUI) were assigned to either group C (＜65 years) or group D (≥65 years). The objective and subjective SPARC success rates were evaluated postoperatively.

Results

There were 258 patients in group A, 43 patients in group B, 44 patients in group C, and 11 patients in group D. The objective surgical success rates for groups A and B were 97.7% and 95.3%, respectively (p=0.304). The subjective success rates for groups A and B were 97.3% and 95.3%, respectively (p=0.311). Recommendation rates for the SPARC procedure were 93% in group A and 93% in group B (p=0.5). In patients with MUI (groups C and D), the objective success rates were 93.2% (group C) and 81.8% (group D) (p=0.286). The subjective success rates were 93.2% (group C) and 81.8% (group D) (p=0.286). The complication rates were similar between the two study groups: 5.4% (group A) vs 7.0% (group B) (p=0.359).

Conclusions

The SPARC procedure is effective and safe, and it offers a satisfactory success rate in elderly women with UI.

Keywords: Aged, Urinary incontinence, Surgery

REFERENCES

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Table 1.

Characteristics of patients undergoing the suprapubic arch procedure

Variables	Group A* (n=258)	Group B^† (n=43)	p-value
Parity (No.)	3.2±1.1	3.4±1.5	NS
Stamey grade
I	93 (36.0)	14 (32.5)	NS
II	157 (60.9)	27 (62.8)	NS
III	8 (3.1)	2 (4.7)	NS
Anti-incontinence surgery (%)	13 (5.0)	2 (4.7)	NS
Previous pelvic surgery (%)	81 (31.4)	15 (34.9)	NS
Cystocele (%)	49 (19.0)	10 (23.3)	NS
Q-max (ml/s)	31.6±2.3	28.9±1.9	NS
Post-void residual (ml)	25.8±5.9	29.1±6.4	NS
Valsalva leak point
pressure (cmH₂O)	59.2±8.6	55.7±8.3	NS
1-hour pad test (g)	35.2±3.3	38.1±3.6	NS

^* : age＜65 years

^† : age≥65 years, NS: not significant

Table 2.

Objective and subjective success rates according to age group

Outcome	Group A* (n=258)	Group B^† (n=43)	Total (n=301)	p-value
Objective
Success (%)	252 (97.7)	41 (95.3)	293 (97.3)	0.304
Cure (%)	232 (89.9)	37 (86)	269 (89.3)
Improved (%)	20 (7.8)	4 (9.3)	24 (8)
Failure (%)	6 (2.3)	2 (4.7)	8 (2.7)
Subjective
Success (%)	251 (97.3)	41 (95.3)	292 (97)	0.311
Satisfied (%)	236 (91.5)	38 (88.4)	274 (91)
Fair (%)	15 (5.8)	3 (6.9)	18 (6)
Dissatisfied (%)	7 (2.7)	2 (4.7)	9 (3)

^* : age＜65 years

^† : age≥65 years

Table 3.

Objective and subjective success rates according to age group in mixed urinary incontinence patients

Outcome	Group C* (n=44)	Group D^† (n=11)	Total (n=55)	p-value
Objective
Success (%)	41 (93.2)	9 (81.8)	50 (90.9)	0.286
Cure (%)	35 (79.5)	8 (72.7)	43 (78.2)
Improved (%)	6 (13.6)	1 (9.1)	7 (12.7)
Failure (%)	3 (6.8)	2 (18.2)	5 (9.1)
Subjective
Success (%)	41 (93.2)	9 (81.8)	50 (90.9)	0.286
Satisfied (%)	36 (81.8)	8 (72.7)	44 (80)
Fair (%)	5 (11.4)	1 (9.1)	6 (10.9)
Dissatisfied (%)	3 (6.8)	2 (18.2)	5 (9.1)

^* : age＜65 years

^† : age≥65 years

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