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[Is initial success after Monarc(®) suburethral sling durable at mid-term evaluation?].
Prog Urol. 2016 Jun; 26(7):409-14.PU

Abstract

OBJECTIVES

Suburethral sling is the gold standard treatment for stress urinary incontinence (SUI). Short-term cure rates are high, but only few studies are available for longer assessment after transobturator tape procedure. The objectives of this study were to assess mid-term functional outcome for Monarc(®) transobturator tape after initial success, and to identify risk factors for recurrence.

MATERIAL AND METHODS

We conducted a single centre retrospective study (2004-2013) on consecutive women with SUI who underwent Monarc(®) transobturator tape procedure and were initially cured at the postoperative medical consultation. Pre- and postoperative data (age, weight, height, body mass index, hormonal status, surgical history, associated organ prolapse [Baden and Walker], associated urinary symptoms, postoperative complications [Clavien-Dindo]) were extracted from the electronic medical record. Subjective cure was defined by a score of zero from the ICIQ-SF questionnaire, no second intervention for recurrent SUI and no need for pads at latest news. Statistical analysis was performed using SAS(®) v9.3 (P<0.05).

RESULTS

One hundred and thirty-three consecutive women underwent TOT Monarc(®) procedure, and 125 women were cured in the short-term. Among these women, 103 (82%) were available for mid-term evaluation. Sixty-four women (62%) had pure stress urinary incontinence. The mean follow-up period was 51 months [2-119]. At last follow-up, cure rate was 61%. Seventy-eight percent of women with recurrent urinary incontinence had SUI. Other women had mixed urinary incontinence (3/40), or de novo urgency (6/40). In univariate analysis, we could not identify pejorative prognostic factors for mid-term failure.

CONCLUSION

In our experience, mid-term functional outcome after Monarc(®) transobturator tape procedure seems to deteriorate. After 4 years of follow-up, 61% of the women who were initially cured were still free from any leakage.

LEVEL OF EVIDENCE

4.

Authors+Show Affiliations

HeRVI EA3801, service d'urologie, transplantation, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France. Electronic address: reem7@hotmail.fr.HeRVI EA3801, service de biostatistiques, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France.HeRVI EA3801, service d'urologie, transplantation, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France; HeRVI EA3801, laboratoire de recherche, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France.HeRVI EA3801, service d'urologie, transplantation, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France.HeRVI EA3801, service d'urologie, transplantation, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France.HeRVI EA3801, service d'urologie, transplantation, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France; HeRVI EA3801, laboratoire de recherche, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France; HeRVI EA3801, centre de ressources biologiques, biobanque de Picardie, CHU d'Amiens, université de Picardie Jules-Verne, avenue R.-Laennec, 80054 Amiens cedex 1, France.

Pub Type(s)

Journal Article

Language

fre

PubMed ID

27032312

Citation

Betari, R, et al. "[Is Initial Success After Monarc(®) Suburethral Sling Durable at Mid-term Evaluation?]." Progres En Urologie : Journal De l'Association Francaise D'urologie Et De La Societe Francaise D'urologie, vol. 26, no. 7, 2016, pp. 409-14.
Betari R, Meynier J, Forzini T, et al. [Is initial success after Monarc(®) suburethral sling durable at mid-term evaluation?]. Prog Urol. 2016;26(7):409-14.
Betari, R., Meynier, J., Forzini, T., François, T., Hakami, F., & Saint, F. (2016). [Is initial success after Monarc(®) suburethral sling durable at mid-term evaluation?]. Progres En Urologie : Journal De l'Association Francaise D'urologie Et De La Societe Francaise D'urologie, 26(7), 409-14. https://doi.org/10.1016/j.purol.2016.03.001
Betari R, et al. [Is Initial Success After Monarc(®) Suburethral Sling Durable at Mid-term Evaluation?]. Prog Urol. 2016;26(7):409-14. PubMed PMID: 27032312.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Is initial success after Monarc(®) suburethral sling durable at mid-term evaluation?]. AU - Betari,R, AU - Meynier,J, AU - Forzini,T, AU - François,T, AU - Hakami,F, AU - Saint,F, Y1 - 2016/03/28/ PY - 2016/01/31/received PY - 2016/02/29/revised PY - 2016/03/01/accepted PY - 2016/4/2/entrez PY - 2016/4/2/pubmed PY - 2017/5/4/medline KW - Bandelette sous-urétrale KW - Incontinence urinaire d’effort KW - Mid-term follow-up KW - Monarc(®) KW - Stress urinary incontinence KW - Suburethral sling KW - Suivi à moyen terme KW - Transobturator tape KW - Transobturator tape (TOT) SP - 409 EP - 14 JF - Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie JO - Prog Urol VL - 26 IS - 7 N2 - OBJECTIVES: Suburethral sling is the gold standard treatment for stress urinary incontinence (SUI). Short-term cure rates are high, but only few studies are available for longer assessment after transobturator tape procedure. The objectives of this study were to assess mid-term functional outcome for Monarc(®) transobturator tape after initial success, and to identify risk factors for recurrence. MATERIAL AND METHODS: We conducted a single centre retrospective study (2004-2013) on consecutive women with SUI who underwent Monarc(®) transobturator tape procedure and were initially cured at the postoperative medical consultation. Pre- and postoperative data (age, weight, height, body mass index, hormonal status, surgical history, associated organ prolapse [Baden and Walker], associated urinary symptoms, postoperative complications [Clavien-Dindo]) were extracted from the electronic medical record. Subjective cure was defined by a score of zero from the ICIQ-SF questionnaire, no second intervention for recurrent SUI and no need for pads at latest news. Statistical analysis was performed using SAS(®) v9.3 (P<0.05). RESULTS: One hundred and thirty-three consecutive women underwent TOT Monarc(®) procedure, and 125 women were cured in the short-term. Among these women, 103 (82%) were available for mid-term evaluation. Sixty-four women (62%) had pure stress urinary incontinence. The mean follow-up period was 51 months [2-119]. At last follow-up, cure rate was 61%. Seventy-eight percent of women with recurrent urinary incontinence had SUI. Other women had mixed urinary incontinence (3/40), or de novo urgency (6/40). In univariate analysis, we could not identify pejorative prognostic factors for mid-term failure. CONCLUSION: In our experience, mid-term functional outcome after Monarc(®) transobturator tape procedure seems to deteriorate. After 4 years of follow-up, 61% of the women who were initially cured were still free from any leakage. LEVEL OF EVIDENCE: 4. SN - 1166-7087 UR - https://www.unboundmedicine.com/medline/citation/27032312/[Is_initial_success_after_Monarc_®__suburethral_sling_durable_at_mid_term_evaluation]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1166-7087(16)00074-9 DB - PRIME DP - Unbound Medicine ER -