Korean J Urol.  2006 Apr;47(4):397-401. 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

• Kim WT
• Kim KT
• Kim JW
• Choe JH
• Lee JS
• Seo JT

• KMID: 1997150
• DOI: http://doi.org/10.4111/kju.2006.47.4.397

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.

Keyword

Urinary incontinence; stress; Treatment outcome

MeSH Terms

Female*
Follow-Up Studies*
Humans
Patient Satisfaction
Pelvic Organ Prolapse
Questionnaires
Suburethral Slings*
Telephone
Treatment Outcome
Urinary Incontinence*
Urinary Retention
Urodynamics

Reference

1. Kim UH, Kim JM, Kim YH, Jeon YS, Kim ME, Lee NK, et al. The prevalence of overactive bladder syndrome and urinary incontinence in young and middle aged women. J Korean Continence Soc. 2003. 7:9–14.

2. Ulmsten U, Petros P. Intravaginal sling plasty (IVS): an ambulatory surgical procedure for treatment of female urinary incontinence. Scand J Urol Nephrol. 1995. 29:75–82.

3. Petros P, Ulmsten U. An integral theory and its method for the diagnosis and management of female urinary incontinence. Scand J Urol Nephrol. 1993. 153:Suppl. 1–93.

4. Nilsson CG, Kuuva N, Falconer C, Rezapour M, Ulmsten U. Long-term results of the tension-free vaginal tape (TVT) procedure for surgical treatment of female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2001. 12:Suppl 2. S5–S8.

5. Ulmsten U, Johnson P, Rezapour M. A three-year follow up of tension free vaginal tape for surgical treatment of female stress urinary incontinence. Br J Obstet Gynaecol. 1999. 106:345–350.

6. Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 1996. 7:81–85.

7. Deval B, Levardon M, Samain E, Rafii A, Cortesse A, Amarenco G, et al. A French multicenter clinical trial of SPARC for stress urinary incontinence. Eur Urol. 2003. 44:254–259.

8. Haab F, Sananes S, Amarenco G, Ciofu C, Uzan S, Gattegno B, et al. Results of the tension-free vaginal tape procedure for the treatment of type II stress urinary incontinence at a minimum follow-up of 1 year. J Urol. 2001. 165:159–162.

9. Hunskaar S, Arnold EP, Burgio K, Diokno AC, Herzog AR, Mallett VT. Epidemiology and natural history of urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2000. 11:301–319.

10. Appell RA. Argument for sling surgery to replace bladder suspension for stress urinary incontinence. Urology. 2000. 56:360–363.

11. Paraiso MF, Walters MD, Karram MM, Barber MD. Laparoscopic Burch colposuspension versus tension-free vaginal tape: a randomized trial. Obstet Gynecol. 2004. 104:1249–1258.

12. Andonian S, Chen T, St-Denis Benoit, Corcos J. Randomized clinical trial comparing suparpubic arch sling (SPARC) and tension-free vaginal tape (TVT): one- year results. Eur Urol. 2005. 47:537–541.

13. Tseng LH, Wang AC, Lin YH, Li SJ, Ko YJ. Randomized comparison of the suprapubic arc sling procedure vs tension-free vaginal taping for stress incontinent women. Int Urogynecol J Pelvic Floor Dysfunct. 2005. 16:230–235.

14. Lim YN, Muller R, Corstiaans A, Dietz HP, Barry C, Rane A. Suburethral slingplasty evaluation study in North Queensland, Australia: the SUSPEND trial. Aust N Z J Obstet Gynaecol. 2005. 45:52–59.

15. Dietz HP, Foote AJ, Mak HL, Wilson PD. TVT and Sparc suburethral slings: a case-control series. Int Urogynecol J Pelvic Floor Dysfunct. 2004. 15:129–131.

16. Kobashi KC, Govier FE. Perioperative complications: the first 140 polypropylene pubovaginal slings. J Urol. 2003. 170:1918–1921.

17. De Tayrac R, Deffieux X, Droupy S, Chauveaud-Lambling A, Calvanese-Benamour L, Fernandez H. A prospective randomized trial comparing tension-free vaginal tape and transobturator suburethral tape for surgical treatment of stress urinary incontinence. Am J Obstet Gynecol. 2004. 190:602–608.