title: [Is initial success after Monarc(®) suburethral sling durable at mid-term evaluation?].
abstract: OBJECTIVE
  Suburethral sling is the gold standard treatment for stress urinary incontinence (SUI). Short-term cure rates are high, but only few studies are available for longer assessment after transobturator tape procedure. The objectives of this study were to assess mid-term functional outcome for Monarc(®) transobturator tape after initial success, and to identify risk factors for recurrence.
  
  
  METHODS
  We conducted a single centre retrospective study (2004-2013) on consecutive women with SUI who underwent Monarc(®) transobturator tape procedure and were initially cured at the postoperative medical consultation. Pre- and postoperative data (age, weight, height, body mass index, hormonal status, surgical history, associated organ prolapse [Baden and Walker], associated urinary symptoms, postoperative complications [Clavien-Dindo]) were extracted from the electronic medical record. Subjective cure was defined by a score of zero from the ICIQ-SF questionnaire, no second intervention for recurrent SUI and no need for pads at latest news. Statistical analysis was performed using SAS(®) v9.3 (P<0.05).
  
  
  RESULTS
  One hundred and thirty-three consecutive women underwent TOT Monarc(®) procedure, and 125 women were cured in the short-term. Among these women, 103 (82%) were available for mid-term evaluation. Sixty-four women (62%) had pure stress urinary incontinence. The mean follow-up period was 51 months [2-119]. At last follow-up, cure rate was 61%. Seventy-eight percent of women with recurrent urinary incontinence had SUI. Other women had mixed urinary incontinence (3/40), or de novo urgency (6/40). In univariate analysis, we could not identify pejorative prognostic factors for mid-term failure.
  
  
  CONCLUSIONS
  In our experience, mid-term functional outcome after Monarc(®) transobturator tape procedure seems to deteriorate. After 4 years of follow-up, 61% of the women who were initially cured were still free from any leakage.
  
  
  METHODS
  4.
authors.affiliation: HeRVI EA3801, service d'urologie, transplantation, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France. Electronic address: reem7@hotmail.fr.
authors.forename: R
authors.initials: R
authors.lastname: Betari
authors.affiliation: HeRVI EA3801, service de biostatistiques, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France.
authors.forename: J
authors.initials: J
authors.lastname: Meynier
authors.affiliation: HeRVI EA3801, service d'urologie, transplantation, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France; HeRVI EA3801, laboratoire de recherche, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France.
authors.forename: T
authors.initials: T
authors.lastname: Forzini
authors.affiliation: HeRVI EA3801, service d'urologie, transplantation, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France.
authors.forename: T
authors.initials: T
authors.lastname: François
authors.affiliation: HeRVI EA3801, service d'urologie, transplantation, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France.
authors.forename: F
authors.initials: F
authors.lastname: Hakami
authors.affiliation: HeRVI EA3801, service d'urologie, transplantation, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France; HeRVI EA3801, laboratoire de recherche, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France; HeRVI EA3801, centre de ressources biologiques, biobanque de Picardie, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France.
authors.forename: F
authors.initials: F
authors.lastname: Saint
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D053825:Suburethral Slings; D013997:Time Factors; D014550:Urinary Incontinence, Stress / Q000601:surgery*
keywords: Bandelette sous-urétrale; Incontinence urinaire d’effort; Mid-term follow-up; Monarc(®); Stress urinary incontinence; Suburethral sling; Suivi à moyen terme; Transobturator tape; Transobturator tape (TOT)