Efficacy and Adverse Effects of Monarc Versus Tension-free Vaginal Tape Obturator: a Retrospective One-year Follow-up Study

Objective: To compare the efficacy and complications of the transobturator tape (Monarc) versus tension-free vaginal tape obturator in local women with urodynamic stress incontinence at the 1-year follow-up. Methods: A retrospective study was conducted in patients who underwent transobturator tape therapy for urodynamic stress incontinence in the period from August 2005 to August 2009 in United Christian Hospital, Hong Kong. A total of 74 patients were recruited, of which 44 had the Monarc procedure performed and 30 were treated by the tensionfree vaginal tape obturator. The objective and subjective cure rates, and complications were reviewed at 1-year post-intervention. Results: There was no statistically significant difference between the groups in terms of objective cure rate or subjective outcome rate. The objective cure rates at the 1-year follow up were 54.1% for Monarc and 79.3% for tension-free vaginal tape obturator, while the respective subjective outcome rates were 83.9% and 87.3%. The postoperative complication rate in our study population was low. There were no differences between the two groups in terms of postoperative fever, urinary tract infection, bladder injury, vaginal perforation, haematoma formation, and analgesic requirements. Functional outcomes including de-novo urgency and voiding dysfunction assessed at the 1-year follow-up were also similar. Conclusion: At the 1-year follow-up, both procedures yielded similar effectiveness and safety for the treatment of urinary stress incontinence in our local population. Hong Kong J Gynaecol Obstet Midwifery 2012; 12:50-4