Sexual function in women with stress urinary incontinence treated with the SPARC sling system.

AIM: To evaluate the impact of SPARC on female sexual function. METHODS: 151 women with a mean age of 60 ± 11.90 and SUI had a complete urodynamic investigation and underwent SPARC operation. 98 women completed the validated female sexual function index questionnaire (FSFI) at baseline and 94 women at follow-up. A minimum follow-up of 12 months was required for study inclusion. RESULTS: 52/98 women were sexually active at baseline. Postoperatively only 33 patients were sexually active. The FSFI score of all 33 pre- and postoperative sexually active women increased from 25.3 ± 5.7 at baseline to 27.4 ± 4.8 at follow-up (P = 0.1). Scores of women with reduced sexual function at baseline increased significantly in the domains desire, arousal, and lubrication as well as orgasm and satisfaction and total FSFI-score (P = 0.002) postoperatively. CONCLUSIONS: Our results suggest that the SPARC-sling procedure for SUI did not negatively interfere with female sexual function.

Clinical impact of body mass index on the outcome of the SPARC-sling system for the treatment of female stress urinary incontinence.

PURPOSE: Of this observational study was to evaluate the clinical outcome of the suprapubic arc (SPARC)-sling system in women with stress urinary incontinence according to body mass index (BMI). MATERIALS AND METHODS: A total of 151 women underwent SPARC between June 2001 and March 2009 at a single tertiary academic center. A complete urodynamic investigation was performed preoperatively. A minimum follow-up of 12 months was required, which left data of 93 individuals for analyses. Participants were divided into the following: A, non-obese (BMI 18.5 to <25 kg/m(2)), B, overweight (BMI 25 to <30 kg/m(2)), and C, obese (BMI 30-35 kg/m(2)). Objective and subjective cure rates, as well as overall success rate and self-perceived severity of bother, were measured. Moreover, participants were asked about their satisfaction after surgery. RESULTS: Median follow-up was 7.6 years. Mean number of pads/day, pad test, and self-perceived severity of bother were significantly reduced overall, as well as in each BMI category (P < 0.001). In multivariable analyses, BMI was not an independent predictor of objective cure rate, coded either as continuous (P = 0.108) or as categorical variable (P for trend 0.301). Similarly, BMI was not an independent predictor of subjective cure rate, both coded as continuous (P = 0.475) and as categorical variable (P for trend 0.690). Overall, 92% (A), 85% (B), and 80% (C) of participants were satisfied with the surgical outcome at follow-up, respectively. CONCLUSIONS: BMI failed to achieve independent predictor status regarding objective and subjective cure rate at follow-up. A high BMI is not a contraindication to SPARC, more studies are recommended to confirm these findings.

Quality of life after SPARC sling procedure: a long-term retrospective analysis.

INTRODUCTION: To asses the effects on quality of life (QoL) in women with stress urinary incontinence after a SPARC sling procedure. METHODS: This is a long-term retrospective study. The study cohort consisted of 54 women: 46 were available for follow-up examination and 8 were contacted by telephone. RESULTS: The median follow-up was 5.3 years. The QoL assessed by using a visual analogue scale improved significantly from 6.9 at baseline to 2.8. The IIQ-7 (Incontinence Impact Questionnaire-Short Form) general score decreased from an average of 56.7 at baseline to 17.5 at the follow-up investigation. Using the Patient Global Impression of Improvement questionnaire, 57.4% of women characterized themselves as very much better, 20.4% as much better and 11.1% as a little better. Eighty-seven percent of women regarded themselves as satisfied, but 13% were dissatisfied with the outcome of the SPARC sling procedure. CONCLUSION: In this study a significant and stable long-term improvement in QoL could be observed in women undergoing SPARC sling procedure.

The suprapubic arch sling procedure for treatment of stress urinary incontinence: a 5-year retrospective study.

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 0-1g 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.