[Is initial success after Monarc(®) suburethral sling durable at mid-term evaluation?].

Area of Science:

• Urology
• Female Pelvic Medicine and Reconstructive Surgery

Background:

• Suburethral sling procedures, particularly the transobturator tape (TOT) method, are standard treatments for stress urinary incontinence (SUI).
• While short-term success rates are high, long-term functional outcomes and recurrence factors after TOT procedures require further investigation.

Purpose of the Study:

• To evaluate the mid-term functional outcomes of the Monarc TOT procedure for SUI.
• To identify potential risk factors associated with the recurrence of SUI after initial successful treatment with the Monarc TOT.

Main Methods:

• A retrospective, single-center study included 133 women who underwent the Monarc TOT procedure for SUI between 2004 and 2013.
• Data on patient demographics, surgical history, and postoperative outcomes were collected, with mid-term evaluation defined by subjective cure (ICIQ-SF score of zero, no further intervention, no pads).

Main Results:

• Of 125 initially cured women, 103 (82%) were available for mid-term follow-up (mean 51 months).
• The overall cure rate at mid-term was 61%, with 78% of recurrent cases presenting as SUI.
• Univariate analysis did not reveal significant prognostic factors for mid-term failure.

Conclusions:

• The Monarc TOT procedure for SUI demonstrates a deterioration in functional outcomes over the mid-term.
• Approximately 61% of women initially cured remained free of leakage at approximately 4 years post-procedure.