Friday, August 05, 2005

SPARC Procedure for Treating Urinary Stress Incontinence

This procedure has been patented by Dr. David Staskin and employs the suprapubic insertion of arced needles (hence SPARC) for the surgical implantation of an adjustable sling that serves to support the urethra.

This procedure treats urinary stress incontinence in women. This is the most common type of incontinence in women. The bladder is supported by muscles of the pelvic floor and if these muscles weaken, the bladder can move downward, pushing slightly out of the bottom of the pelvis toward the vagina. This prevents muscles that ordinarily force the urethra shut from squeezing as tightly as they should. As a result, urine can leak into the urethra during moments of physical stress and even mundane things such as exercise, coughing, and sneezing.

The Procedure:
This procedure is done through a ‘top-down’ (suprapubic) approach that inserts needles into the abdomen and out of the vagina. This is in contrast to other sling procedures such as the Tension Free Tape (TVT) procedure that uses a ‘bottom-up’ approach inserting needles into the vagina and out of the abdomen. There is less risk involved with the suprapubic technique of the SPARC procedure addressing the complications that have resulted from TVT use. This is an outpatient procedure that takes 20-30 minutes.

First two suprapubic incisions are made for insertion of the needles

Next a suburethral incision is made for insertion of the sling

The needles are then inserted into the abdomen and through the vaginal incision

A cystoscopy is then performed to ensure that there is no damage to the urethra or abdomen

Then sling is then snapped onto the ends of the needles and the needles are pulled out from the abdomen thereby placing the sling around the urethra

The plastic sheath covering the sling is removed and the excess sling is trimmed

The sling can be adjusted to provide the correct support and the abdominal incisions are closed and the vaginal incision is closed

Images courtesy of Dr. David Staskin



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