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Kim, Kim, Kim, Choe, Lee, and Seo: Comparative Study of the Tension-Free Vaginal Tape (TVT) Procedure and the Suprapubic Arc Sling (SPARC) Procedure for Treating Female Stress Urinary Incontinence: a 1-Year Follow-Up
Original Article
Korean Journal of Urology

Korean Journal of Urology 2006; 47(4): 397-401.

Published online: 30 April 2006

DOI: https://doi.org/10.4111/kju.2006.47.4.397

Comparative Study of the Tension-Free Vaginal Tape (TVT) Procedure and the Suprapubic Arc Sling (SPARC) Procedure for Treating Female Stress Urinary Incontinence: a 1-Year Follow-Up

Won Tae Kim, Kyung Tae Kim, Jong Woo Kim, Jin Ho Choe, Joong Shik Lee, Ju Tae Seo

Department of Urology, Sungkyunkwan University School of Medicine, Seoul, Korea.

Corresponding author (jtandro@skku.edu)

Received 16 August 2005       Accepted 6 December 2005

Copyright © 2006 The Korean Urological Association

Abstract

Purpose

We wanted to compare the efficacy and outcomes of two retropubic mid-urethral sling procedures, tension-free vaginal tape (TVT) and suprapubic arc sling (SPARC), in the women suffering with stress urinary incontinence (SUI).

Materials and Methods

A total of 124 women with SUI were assigned to either the TVT group (n=62) or the SPARC group (n=62) within a same period. Only the patients with a follow-up of at least 12 months were included and those patients who underwent conjoined pelvic reconstructive surgeries for coexisting pelvic organ prolapse were excluded from this study. Finally, 90 patients (TVT: 42, SPARC: 48) remained in the study. The objective cure rate was evaluated by clinical and urodynamic examinations; the satisfaction rate was determined by using a questionnaire via the telephone or a self-addressed, stamped envelope. The mean follow-up period was 16.3 months in the TVT group and 16.3 months in the SPARC group.

Results

Two groups were similar in their preoperative characteristics and the perioperative parameters. There was no significant difference between the 2 groups in terms of the cure rate: cure (91.7% vs. 100%, p=0.056), improvement (6.2% vs. 0%, p=0.099), and failure (2.1% vs. 0%, p=0.347) for SPARC and TVT, respectively. In addition, the patient satisfaction rate was not different significantly between 2 groups. The main complication was urinary retention, and this was diagnosed in 6 patients; 3 (7.1%) in the TVT group and 3 (6.3%) in the SPARC group. De novo urge symptoms were observed in 3 patients (1 in the TVT group and 2 in the SPARC group).

Conclusions

SPARC sling and TVT appears to be equally effective and safe for the surgical treatment of female SUI at the 1-year follow-up, although further studies are needed to establish the long-term efficacy and safety of these procedures.

Keywords: Urinary incontinence, stress, Treatment outcome

Figures and Tables

Table 1
Characteristics of the patients and the preoperative clinical parameters
kju-47-397-i001

SPARC: suprapubic arc sling, TVT: tension-free vaginal tape, Qmax: maximum flow rate, PVR: post void residual, Pdet at Qmax: detrusor pressure at maximum flow rate, MUCP: maximal urethral closure pressure, ALPP: abdominal leak point pressure, NS: not significant

Table 2
Cure rate and satisfaction of the patients
kju-47-397-i002

SPARC: suprapubic arc sling, TVT: tension-free vaginal tape, NS: not significant

Table 3
Comparison of the intraoperative and postoperative parameters
kju-47-397-i003

SPARC: suprapubic arc sling, TVT: tension-free vaginal tape, UFM: uroflowmetry, Qmax: maximum flow rate, PVR: post void residual, NS: not significant

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