title: Multicenter experience with the Monarc transobturator sling system to treat stress urinary incontinence.
abstract: This study was conducted to report on the safety and efficacy of a transobturator sling approach for treatment of urodynamic stress incontinence (USI). Women with urodynamic stress incontinence were offered a novel polypropylene mesh sling procedure, implanted beneath the lateral pubic rami rather than retropubically. Retrospective data were collected at three U.S. sites. Two hundred women with a mean age of 59 years (range 27-93) underwent the sling procedure. Mean follow-up was 21.5 weeks (range 3-43). Perioperative safety parameters are reported for all subjects and efficacy parameters for those who were followed up for 26 weeks or more. Among the subjects, 95.3% reported being continent or substantially continent (occasional leakage of small amounts, with protection not needed). Mean operative time was 13.8 min (range 7-34). Preoperatively, 75% wore pads, with 5.3% continuing to do so at 26 weeks. Pre-op urgency was reported by 62.7%, with 41.5% receiving medication. Urgency was reported postoperatively by 20.5% of patients, but only 13.6% were medicated for urgency. Urinary retention was identified in 0.9% at 26 weeks. Transobturator slings are highly effective for treatment of SUI, and may offer increased safety relative to traditional and tension-free retropubic slings.
authors.affiliation: Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL 33331, USA. davilag@ccf.org
authors.forename: G W
authors.initials: GW
authors.lastname: Davila
authors.forename: J D
authors.initials: JD
authors.lastname: Johnson
authors.forename: S
authors.initials: S
authors.lastname: Serels
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D053825:Suburethral Slings; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000628:therapy*