Comparison of the efficacy and safety of suprapubic arc sling and transobturater vaginal tape for the treatment of female stress urinary incontinence / 中华泌尿外科杂志

ABSTRACT

Objective To analyze the efficacy and safety of suprapubic arc sling (SPARC) and transobturater vaginal tape (TOT) for female stress urinary incontinence (SUI). Methods A retrospective study was conducted on 275 women ( 139 in TOT group and 136 in SPARC group) in our institute from September 2008 to January 2011.We had compared the complications of the two groups.All the patient's ICI-Q-SF scores and PISQ-12 scores were collected.We compared the pre- and post-operative Qmax and PVR to find out if SPARC or TOT tap cause bladder outlet obstruction (BOO). Results The operative time was 25.1 ± 3.3 min for TOT and 34.8 ± 5.6 min for SPARC.There was statistical difference between the two groups in the aspects of operative time (P =0.00).The improvements of average symptom and QOL scores in patients undergoing TOT and SPARC were statistically significant (P =0.00).The improvements of the PISQ-12 scores in the two groups were statistically significant (P ＜0.05 ) as well.There was no significant difference (P ＞ 0.05 ) in the total cure rate of TOT and SPARC.The complications post SPARC and TOT were low.In the TOT group,the Qmax changed from 30.2 ± 8.7 ml/s per-operatively to 24.9 ± 8.6 ml/s post-operatively in a week.PVR changed from 1.6 ± 4.2 ml pre-operatively to 3.2 ± 6.5 ml post-operatively in a week.In the SPARC group,the Qmax changed from 31.7 ±9.4 ml/s pre-operatively to 26.9 ± 8.9 ml/s post-operatively in a week.PVR changed from 1.4 ± 3.7 ml pre-operatively to 3.5 ± 6.3 ml postoperatively in a week.All the changes were significant ( P ＜ 0.05 ).And in the SPARC group,the Qmax changed from 31.2 ± 10.0 ml/s pre-operatively to 26.2 ± 9.1 ml/s post-operatively; the PVR changed from 1.8 ± 3.2 ml pre-operatively to 4.7 ± 8.8 ml post-operatively (P ＜ 0.05). Conclusions Both the TOT sling and the SPARC sling have high cure rates for SUI.But the retropubic sling may lead to BOO and other complications,so the transobturate sling is a better treatment option for SUI.