title: Five-year follow-up study of Monarc transobturator tape for surgical treatment of primary stress urinary incontinence.
abstract: OBJECTIVE
  We hypothesized that transobturator tape (TOT) is safe and efficacious for the treatment of urodynamic stress incontinence in the long term.
  
  
  METHODS
  We conducted a prospective study of patients with confirmed urodynamic stress incontinence (USI) who underwent a MonarcTMTOT procedure in a tertiary center between February 2006 and March 2009 without other concurrent surgical procedures. Urodynamics were conducted at 1 and 3 years postoperatively. Subjective evaluation included Incontinence Impact Questionnaire (IIQ-7), Urinary Distress Inventory Questionnaire (UDI-6), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Objective cure was defined as no urinary leakage demonstrable on provocative filling cystometry and/ or 1-h pad test of <2 g. Subjective cure was based on a negative response to question 3 in UDI-6. Paired-samples t test, chi-square, and Fisher exact tests were applied; p < 0.05 was considered significant. The log-rank tests were used to compare event-free survival.
  
  
  RESULTS
  Sixty patients were enrolled, and 56 were evaluated at 5 years postoperatively. The majority were middle aged, postmenopausal, and overweight. Mean operating time was 31.1 ± 8.9 min, intraoperative complications were minor, and median period of follow-up was 80.3 ± 9.6 months. At 5 years of follow-up, objective and subjective cure rates were 89.3 % and 87.5 %, respectively. No mesh-related complications were seen. One patient needed a repeat midurethral sling procedure, and one patient each had bladder and bowel cancer.
  
  
  CONCLUSIONS
  Monarc TOT was safe and retained its high cure rate in the short- and long-term treatment of stress urinary incontinence.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung, Medical Center, 222, Maijin Road, Keelung, Taiwan, Republic of China. 2378@cgmh.org.tw.|Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei Medical Center, Taipei, Taiwan, Republic of China. 2378@cgmh.org.tw.|Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China. 2378@cgmh.org.tw.|School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China. 2378@cgmh.org.tw.
authors.forename: Tsia-Shu
authors.initials: TS
authors.lastname: Lo
authors.affiliation: Department of Obstetrics and Gynecology, Sarawak General Hospital, Kuching, Sarawak, Malaysia.|Fellow of the Division of UroGynecology, Department of Obstetrics & Gynaecology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
authors.forename: Sukanda
authors.initials: S
authors.lastname: Jaili
authors.affiliation: KPJ Healthcare Group, Kuching Specialist Hospital, Kuching, Sarawak, Malaysia.
authors.forename: Yiap Loong
authors.initials: YL
authors.lastname: Tan
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung, Medical Center, 222, Maijin Road, Keelung, Taiwan, Republic of China.
authors.forename: Pei-Ying
authors.initials: PY
authors.lastname: Wu
mesh_terms: D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D053825:Suburethral Slings; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics
keywords: Midurethral sling; Monarc transobturator tape; Stress urinary incontinence; Urodynamic stress incontinence