SPARC sling system for treatment of female stress urinary incontinence in the elderly

To investigate the safety and efficacy of the suprapubic arch (SPARC) sling procedure for the management of stress urinary incontinence (SUI) in elderly women. Method: Forty-three women, aged 65-91 yr, underwent the SPARC procedure for urodynamic SUI. Before surgery, a complete medical history was obtained and a urogynecology examination and urodynamic test were performed. The objective cure rate was evaluated by clinical and urodynamic examination at 3, 6, and 12 mo and the subjective cure rate was assessed using a visual analogue score and a global patient impression questionnaire. Results: No severe intraoperative or postoperative complications occurred. No patient referred de novo urge incontinence. Significant differences were found between the preoperative and postoperative number of daytime voidings (p < 0.001), the pad weights and numbers of pads used (p < 0.001), and the visual analogue score (p = 0.021). No significant differences in preoperative and postoperative urodynamic parameters were reported. At the mean follow-up of 36 ± 14 mo (range, 12-54 mo), objective and subjective cure rates were 91% and 95%, respectively. Conclusions: The SPARC procedure is effective and offers a satisfactory cure rate without significant morbidity in elderly women with