Perioperative Complications and Adverse Events of the Monarc Transobturator Tape, Compared with the Tension-Free Vaginal Tape

Barber MD, Gustilo-Ashby AM, Chen CCG, Kaplan P, Paraiso MFR, Walters MD.
Am J Obstet Gynecol 2006 epub.

The study found the Monarc TOT is a safe procedure that may have a lower complication rate than the TVT, particularly with regard to bladder injuries and postoperative voiding dysfunction.

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Prospective Multicentre Trial of Monarc Transobturator Sling for stress Incontinence: 24 Month Functional Data

Deridder D, Jacquetin B, Fischer A, Debodinance P, Marques Queimadelos A, Courtieu C, Cervigni M, rassler J, Rane A, Herschorn S, Urwin G, Goetze, Ouellet S, Schrader M, Mellier G
Eur Urol Apr 2006;5(2 suppl.): 267 abstract 978. 21st Annual Congress of the European Association of Urology

Twenty-four month data show that Monarc® transobturator sling successfully restores continence in women with SUI. Patient and physician assessed continence rate (completely dry and substantially continent) were both 82%. UDI-6 and HQ-7 were significantly improved from baseline. Given the 11.5% of patients with de novo urge and the 27.9% of patients who were cured of their pre-operative urge, patients implanted with Monarc are significantly more likely to be cured of urge symptoms than to develop urge symptoms (p < 0.005).

** Journal on file at AMS

An Anatomical Study of the Obturator Foramen and Dorsal Nerve of the Clitoris and their Relationship to Minimally Invasive Slings

Achtari C, Mckenzie BJ, Hiscock R, Rosamilia A, Schierlitz L, Briggs CA, Dwyer PL.
Int Urogynecol J Jun 2006;17(4):330-4.

This study found significant differences between the TVT-O and Monarc transobturator devices and their proximity to the obturator canal on average, the Monarc was located 0.8 cm further away from the obturator canal than TVT-O. There was no significant difference to the DNC, with Monarc possibly being the safest given its outside-in course.

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TVT vs Monarc: A Comparative Study

Dietz H P, Barry C, Lim Y, Rane A.
Int Urogynecol J. Pelvic Floor Dysfunct Nov 2006;17(6):566-9

This comparative study of 114 women after Monarc and TVT surgery demonstrated that the mode of action of transobturator tapes seems to be largely identical to that of TVT-type slings. However, the Monarc tape seems to have less effect on voiding and is associated with less postoperative urge incontinence. Possibly as a consequence, the transobturator tape was associated with higher patient satisfaction and subjective overall cure/improvement at approximately 9 months follow-up.

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Transobturator Versus Transabdominal Mid Urethral Slings: A Multi-Institutional Comparison of Obstructive Voiding Complications

More AF, Medendorp AR, Noller MW, Mora RV, Shandera KC*, Foley JP, Rivera LR, Reyna JA, Terry PJ.
J Urol Mar 2006;174:1014-1017

Although transobturator and transabdominal sling procedures had similar short-term results for decreasing pad use in patients with stress urinary incontinence, the transobturator approach is associated with fewer obstructive voiding complications.

* AMS employee

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Multicenter Experience with the Monarc® Transobturator Sling System to Treat Stress Urinary Incontinence

Davila GW, Johnson JD, Serels S.
Int Urogynecol J Sep 2006;17(5):460-465

Monarc transobturator slings are 95.3% effective for surgical treatment of SUI at 6 months and may offer increased safety relative to traditional or tension-free retropubic slings.

Funding for data collection was provided by American Medical Systems.

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In Vivo Comparison of Suburethral Sling Materials

Slack M, Sandhu JS, Staskin DR, Grant RC*.
Int Urogynecol J 2006;17:106-110.

In vivo tissue responses were compared for three commercially available polypropylene suburethral slings that differ markedly in fabric structure and in size of resulting interstices and pores. All three elicited the same basic inflammatory response; however, individual fabric structures produced distinct differences in tissue formation within each mesh. The presence of numerous, closely spaced, small diameter filaments prevented formation of extensive fibrous connective tissue within two slings (ObTapeTM and IVS Tunneller mesh). The much larger diameter monofilament and open knit structure of the Monarc® sling permitted the most extensive fibrous tissue integration.

* AMS employee

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