여성 복압성요실금 환자에서 TVT와 SPARC 술식의 비교: 1년 추적 결과
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
김원태, 김경태, 김종우, 최진호, 이중식, 서주태,
소속 상세정보
김원태 ( Kim Won-Tae )
성균관대학교 의과대학 비뇨기과학교실
김경태 ( Kim Kyung-Tae )
성균관대학교 의과대학 비뇨기과학교실
김종우 ( Kim Jong-Woo )
성균관대학교 의과대학 비뇨기과학교실
최진호 ( Choe Jin-Ho )
성균관대학교 의과대학 비뇨기과학교실
이중식 ( Lee Joong-Sik )
성균관대학교 의과대학 비뇨기과학교실
서주태 ( Seo Ju-Tae )
성균관대학교 의과대학 비뇨기과학교실
KMID : 0358320060470040397
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. (Korean J Urol 2006;47:397-401)
키워드
Urinary incontinence;stress; Treatment outcome
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