Tension-free obturator tape (Monarc Subfascial Hammock) in patients with or without associated procedures

Méllier, G; Mistrangelo, Emanuela; Lamblin, G.; Chabert, Philippe; Mathevet, Patrice

doi:10.1007/s00192-006-0126-6

Cited by 34 publications

(27 citation statements)

References 23 publications

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“…In a previous study comparing TVT with or without concomitant procedure, more complications were reported after TVT with concomitant surgery than after TVT alone, but cure rates did not differ statistically significantly [23]. In addition, Mellier et al [17] concluded that pelvic floor defects, benign uterine disorders, and SUI can be safely treated concomitantly using vaginal procedures and TOT.…”

Section: Discussionmentioning

confidence: 97%

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Transobturatoric tape procedure for female stress urinary incontinence

et al. 2008

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To assess the efficacy and safety of the transobturatoric tape (TOT) procedure as a treatment for female stress urinary incontinence (SUI). All patients (n=191) who underwent TOT between May 2003 and December 2004 were studied retrospectively. The study protocol involved recording of preoperative and perioperative details and postoperative subjective evaluation. The subjective outcome was assessed with two questionnaires at a mean of 20 and 34 months after the operation. The mean operation time of the patients without concomitant procedure was 19 min. The complication rate was low and postoperative recovery quick. The follow-up visit was scheduled 2-3 months after the procedure. The objective outcome assessment was done at the hospital for 50% of the patients, and the other half of the patients were followed up by their own gynecologist. During the follow-up visit (n=151), 79% of the women were cured: 90% of the patients with genuine SUI and 60% of those with mixed urinary incontinence (MUI). The data of 40 patients was either not available from patients' private gynecologists or the patients had not undergone a follow-up visit at all. For the first subjective outcome assessment, participating patients (n=188) received a questionnaire. Three patients had died from unrelated causes during this follow-up. The response rate was 82.4%. Overall, 83.9% of the respondents reported significant improvement, of which 90.5% of the patients had genuine SUI and 70.0% of the patients had MUI, respectively. During the second outcome assessment, the response rate was 85.1% (160/188). At a mean of 34 months postoperatively, 87.5% of the patients reported significant improvement: 94.5% of the patients with genuine SUI and 72.0% of those with MUI. The incontinence operation through the transobturatoric route is a safe and effective treatment, especially for patients with pure SUI. The rate of continence was sustained during a follow-up of 34 months.

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Section: Discussionmentioning

confidence: 97%

“…Urinary incontinence has an influence on quality of life and self-confidence. Recently, subjective outcome measurements have also been included in the postoperative evaluation of incontinence surgery [16][17][18][19]. In one study [19], the subjective cure rate was reported to be significantly greater than the objective cure rate.…”

Section: Discussionmentioning

confidence: 99%

Transobturatoric tape procedure for female stress urinary incontinence

et al. 2008

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“…Un aspecto que consideramos importante, es si los buenos resultados obtenidos por el creador de la nueva técnica quirúrgica son obtenidos por otros grupos de trabajo y a este respecto observamos que los datos son reproducibles en todas las series, incluida la nuestra (Tabla 5) 9, 13,14,[17][18][19] .…”

Section: Discussionunclassified

TOT en el tratamiento de la incontinencia de esfuerzo: nuestra experiencia, comparándola con la TVT

et al. 2007

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Introducción: En el año 2004 iniciamos la técnica de TOT para el tratamiento de la incontinencia urinaria de esfuerzo. En este estudio comparamos los resultados con las series publicadas de TOT y con la serie de TVT realizadas en nuestro servicio.Material y métodos: Hemos intervenido a 171 pacientes, con una edad media de 57,7 años. En el 167% de ellas, además de realizar TOT, asociamos reparación de defectos anatómicos pélvicos.Resultados: Con un seguimiento medio de 12 meses y mediana de 14 meses, el 87% de las pacientes están curadas. Los fracasos aparecieron de forma precoz en los 3 primeros meses de seguimiento. Como complicaciones aparecieron, retenciones post-operatorias de menos de 30 días en el 2,7%, retenciones a largo en el 4,8%, hematomas post-quirúrgicos en el 1,3%, extrusión de la malla en el 2% y urgencia de novo en el 2.3%. Conclusiones: La TOT es una técnica no exenta de complicaciones aunque la proporción de ellas es baja y con unos resultados que son alentadores. Se trata de una técnica quirúrgica sencilla, que como toda técnica, tiene una curva de aprendizaje. Requiere un corto tiempo quirúrgico (menor que la TVT) y puede ser realizada en régimen de Cirugía Mayor Ambulatoria. Las dos técnicas (TVT/TOT) han demostrado ser similares en cuanto a tasas de curación aunque en la serie de TOT es levemente más baja. Las diferencias de las complicaciones se dan en los porcentajes aunque siempre escasas.Palabras clave: TVT. TOT. Incontinencia de esfuerzo. ABSTRACT TOT IN THE TREATMENT OF THE STRESS URINARY INCONTINENCE: OUR EXPERIENCE,COMPARING IT WITH THE TVT Introduction: In the year 2004 begin the technique of TOT for the treatment of the urinary incontinence of effort. In this study we compare the results with the published series of TOT and with the series of TVT carried out in our service.Material and methods: We have intervened to 171 patients, with a 57.7 year-old half age. In their 16%, besides carrying out TOT, we associate repair of anatomical pelvic defects.Results: After a follow-up of 12 months and a mean of 14, 87% of the cases succeeded. Failures arose during the first three months of therapy. As complications they appeared post-operative retentions of less than 30 days in 2.7%, retentions to long in 4.8%, post-surgical hematomas in 1.3%, extrusion of the mesh in 2% and novo urgency in 2.3%.Conclusions: TOT is a technique it doesn't exempt of complications although their proportion is low and with some results that they are encouraging. It is about a surgical simple technique that as all technique, he/she has a learning curve. It requires a surgical (smaller than TVT) short time and it can be carried out in régime of bigger Ambulatory Surgery. The two techniques (TVT / TOT) have demonstrated to be similar as for cure rates although in the series of TOT it is slightly more baja. Las differences of the complications they are given in the percentages although always scarce.

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“…It allows for the tensioning adjustment of the mesh after placement. 2,3 Monarc has this feature. However, ALIGN has no absorbable tensioning suture.…”

Section: Introductionmentioning

confidence: 89%

“…Surgical procedure was carried out as previously described. 3,8 A urinary catheter was inserted after operation and removed, which is often done after 24 hours. After urinary catheter removal, patients were evaluated for flow rate (Portaflow Advanced, Mediwatch, Williston, VT, U.S.) and PVR volumes using ultrasound scanning (Biocon-500, M-cube Technology).…”

Section: Surgical Procedures and Followupmentioning

confidence: 99%

A sequential comparison of postoperative voiding function between two different transobturator sling procedures

Choi

Jung

Lee

et al. 2016

CUAJ

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Introduction: We evaluated sequential postoperative voiding function of two types of sling procedures (Monarc ® and ALIGN ® ) in patients with stress urinary incontinence. Methods: Ninety-one women diagnosed with urodynamic stress incontinence were randomly assigned to the study. All enrolled patients underwent Monarc or ALIGN procedure. They were postoperatively evaluated at one day, one week, one month, three months, 12 months, and 24 months. The voiding function was evaluated with uroflowmetry and post-void residual urine. Patients were asked if voiding had changed after surgery and had to complete the incontinence quality of life scale (I-QoL) questionnaire at 12 months. Results: The Monarc (n=47) and ALIGN (n=44) groups had similar demographic characteristics. The maximal flow rate (Qmax) was significantly decreased on the first day after surgery and gradually increased during the following weeks. Comparing the two groups at one week, the ALIGN group had a significantly decreased Qmax than the Monarc group (17.6 ± 5.2 vs. 20.7 ± 5.0; p=0.004). However, at one, three, 12, and 24 months, there were no significant differences between the two groups. Conclusions: This study demonstrated that an absorbable tensioning suture in the Monarc mesh could increase Qmax compared to ALIGN at one week after surgery. An absorbable tensioning suture may reduce the risk of an early postoperative voiding dysfunction compared to other meshes that do not have this.

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Tension-free obturator tape (Monarc Subfascial Hammock) in patients with or without associated procedures

Cited by 34 publications

References 23 publications

Transobturatoric tape procedure for female stress urinary incontinence

Transobturatoric tape procedure for female stress urinary incontinence

TOT en el tratamiento de la incontinencia de esfuerzo: nuestra experiencia, comparándola con la TVT

A sequential comparison of postoperative voiding function between two different transobturator sling procedures

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