In a nutshell
This study investigated the long-term safety and effectiveness of the Monarc transobturator tape (TOT) approach. Researchers reported a high cure rate and low rate of complications of the Monarc TOT after 5 years.
Some background
Vaginal sling procedures are the most common type of surgery used to help control stress urinary incontinence. The transobturator tape (TOT) approach is a minimally invasive vaginal sling procedure. It is a widely adopted approach that involves the placement of a narrow mesh tape underneath the urethra (urine tract). This helps lift the urethra to its normal position and close more tightly. Monarc is a brand name for such a tape. Since women are likely to live with vaginal slings for many years, long-term studies are needed to address their safety and effectiveness.
Methods & findings
This study aimed to examine the safety and effects of the Monarc TOT over 5 years.
60 women with stress urinary incontinence were included in this study. All women received treatment with Monarc TOT. Treatment outcomes were followed in for 5 years.
Urinary symptoms were significantly improved at the first follow-up (after 1 year). 5 years after the procedure, 89.3% of women achieved continence (no urine leakage during stress test). Self-reported continence (urinary symptom questionnaire) at 5 years was 87.5%.
No significant complications during or after surgery (such as mesh tape exposure) were observed. The average operating time was 31.1 minutes. 5 women had recurrent stress incontinence at 3 years. 1 woman required repeat incontinence surgery. None of the women reported groin or thigh pain during the 5-year follow-up.
The bottom line
Researchers concluded that the Monarc TOT is a safe and effective long-term treatment for stress urinary incontinence.
Published By :
International urogynecology journal
Date :
Apr 16, 2016
And what about women like me when it goes horribly wrong and is looking at a very complicated removal and wondering what the final outcome will be !!
Total disaster . I have leg pain , hip pain just to mention a few. Had the monarc implanted in 2009. Never should have been allowed to be used in women. Causes forgein body problems etc etc. not enough research was done and has left a lot of women damaged.
Did anyone have re-occuring UTI’s for years following this proceedure?
Yes i have. I had them slmost weekly gor many years and went from one antobiotic to another with various doctors stating it is impossible that the UTI’s are caused by the sling . I however disagree. Lately i started inserting a tampon with coconut oil the moment i feel a tingly, itchy or burning sensation. I felt immediate relief and have not used antibiotics for a full year now.
Hi Bronwynn. I had the monarc sling in 2013. I have had UTI’s so many times since having this operation. I have just had 3 UTI’s in the last 4 months. I am worried that because I have so many antibiotics that I will get ammuned to them.
Does the tampon with coconut oil reall work? I am willing to try anything now.
Hi Diane
I only saw your message today. I started being hypervigilant after suffering with numerous UTI’s over the years. This meant that I would smell something off when urinating, and immediately start putting a tampon with a mixture of coconut oil and tee tree oil for about an hour or two. Sometimes I would experience vaginal itching/burning deep inside and would follow the same method as above. I also found that using cranberry capsule plus 100% cranberry juice helps alleviate or eliminate symptoms for a few months.
I have become immune to antibiotics after having UTI’s so often. There is something triggering the irritation which leads to infections, which have infected my kidneys too . So it is a dangerous intervention and the trade off is quite high. ‘m seeing my urologist in the next week and will request that he remove the sling.
Let me know if you try the cranberry and tampon relief and whether it helps at all.
Best wishes
Bronwynn
I had the procedure 8 years ago and I suspect I’m beginning to leak again. I have been happy since surgery…until now.
I had this surgery done 8 years ago and now the mesh is protruding into the vagina. Sex is out of the question. The urologist said he has to take it out and let it heal. He said in 80 percent of the cases another mesh will not be necessary due to the scar tissue supporting the urethra. He said that he cannot put a new one in at the same time taking the old one out. Why not. I don’t want to keep going through this. Have you heard of the scar tissue acting as a sling?
Goodness no never heard of that yet. Please do put an update on here if you do have the removal surgery done. I have had mine for 10 years and understand from my urologist that the sling has a 15 year life span-he hever mentioned anything about scar tissue acting as a replacement if it needed to come out after the 15 years
Yes, my Dr said the same thing – in some cases the scar tissue helps.
My daughter had the Monarc transobturator tape sling done in 1996. she has had UTIs after having intercourse since she had the surgery. She has a standing order for Bactrim! About six months ago she started to get very sick. Extreme pain on the left side of her body, above the waist, changes in her left breast, terrible lethargy, depression, anxiety…..I could go on and on. She has seen several doctors and no one has found anything. My daughter was a vibrant, extremely talented young woman, who ran her own business, but now finds it hard to even get out of bed in the mornings. My son-in-law remembered the “sling” about a week ago, and now we’re wondering if the mesh might have something t do with her illness. If anyone out there has had any of these problems, PLEASE LET US KNOW!! Wishing you all the best.
Yes, there is an Australia Facebook page for sufferers and many have suffered fatigue and terrible pain
What is the page called
I had a monarch sling put in in 2014 and have had continuous and increasing pain from the device since then. So far I have had 3 procedures to either excise the tape/mesh or injections of cortisone, Botox and local
anaesthetic to control the pain. Nothing works. I take 3 medications daily and the pain down my left side is still unbearable especially at night.
I’ve just had mine removed. I’m really hoping they got it all out, though they only found 8cms which the FB group says is a bit short! So I may still have some floating around in there.
If you have complications contact the hospital where it was installed and request the billing documents and Surgical notes with the brand name, type of device, model type number, lot number. You will require that information to report adverse effects to your local authorities- this is not legal advice- you cannot make a report without that information and they seem to with-hold that critical information from us. Maybe then they will have accurate information compiled about the failure rates and complications associated with these products. Do not rely on your doctors to make these reports on your behalf.
My wife had her Monarc transobturator sling installed in 2007. In Sept; 2019 she had constant nausea, which became progressively worse. She later suffered fecal retention, bloating, pressure in her abdomen, and urinary leakage. She had the sling removed 7/8/20, and has felt better ever since. We were never told of any time limit on this thing.