Prospective randomized comparison of transobturator suburethral sling (Monarc) vs suprapubic arc (Sparc) sling procedures for female urodynamic stress incontinence

Abstract

The aims of this trial were to compare the attendant complications and postoperative voiding function of the Monarc and suprapubic arc (Sparc) suburethral sling procedures. This is the first article in English literature to compare different suburethral sling procedures using prosthesis of the same material and the same weave. Sixty women with urodynamic stress incontinence alone or combined with pelvic prolapse less than International Continence Society stage II were randomly allocated to either the Monarc or Sparc group. A comparison of the peri- and postoperative results comprising complications and symptoms of voiding function revealed no significant differences between the two groups in a follow-up ranged from 6 to 14 months (median, 9 months). However, the nonsignificant increase in tendency of inadvertent vaginal perforation and disability/pain of thigh (Monarc 12.9 vs Sparc 0.0%, p=0.112 and Monarc 12.9 vs Sparc 0.0%, p=0.112, respectively) has clinical significance. Based on the analyses of the comparison of Blaivas obstruction nomograms, postoperative voiding function was not significantly different between the two surgical groups. We concluded that Monarc and Sparc suburethral taping proved to be equally safe and posed no remarkable impact on voiding function in a short term postoperative follow up. However, intraoperative urethrocystoscopy is recommended for safety in both the Monarc and Sparc procedures.

The Analysis of The Efficacy and Safety of TransobturatorSling Operation by Using an Adjustable Sling Device in TheTreatment of Stress Urinary Incontinence

“…While it was reported that these complications could be seen in TVT procedure with the rate %2-4, no significant hemorragical complication has been reported in TOT operation. It was accepted that TOT procedure could minimize the occurrence of this kind of complications (28,29). It was seen that no major complication related to the TOT operation, such as bladder perforation, bowel perforation, urethral perforation, vessel injury, and obturator hematoma, occurred in our study.…”

Complications and short-term results of two different transobturator techniques for surgical treatment of women with urinary incontinence: a randomized study

“…Results show that the success of the operation is comparable with retropubic procedures, but compared to these, the transobturator approach involves far less complications [3,4]. To carry out the operation, a monofilament polypropylene tape is introduced and placed under the urethra by two approaches.…”

A retrospective comparative series comparing monarc and sparc suburethral slings

“…In 2005 [11] a prospective randomised trial of 60 patients compared Sparc and Monarc slings, and reported similar success rates at a mean follow up of 9 months.…”