Perioperative complications and adverse events of the MONARC transobturator tape, compared with the tension-free vaginal tape

ObjectiveThe objective of the study was to compare the incidence of perioperative complications of the MONARC transobturator tape with the tension-free vaginal tape in women undergoing surgical treatment for stress urinary incontinence.Study designA retrospective review of all patients undergoing either a transobturator tape or tension-free vaginal tape between January 2003 and August 2005 was performed. The incidence of intraoperative and postoperative (6 weeks or less) complications was compared between groups.ResultsTwo hundred five women underwent a transobturator tape and 213 women underwent a tension-free vaginal tape during the study period. Tension-free vaginal tape resulted in a significantly higher rate of bladder perforation than did transobturator tape (11 of 213 [5%] versus 0 of 205 [0%], P < .001). Postoperatively, subjects who received tension-free vaginal tape were significantly more likely to require urethrolysis for voiding dysfunction or urinary urgency (adjusted odds ratio 3.2 [95% confidence interval 1.2 to 10.1], P = .026) and more likely to use anticholinergic medications (adjusted odds ratio 2.1 [95% confidence interval 1.02 to 4.70], P = .046) than those who received a transobturator tape.ConclusionTransobturator tape is associated with a lower rate of bladder injury, a decreased incidence of postoperative anticholinergic medication use, and fewer urethrolyses for postoperative voiding dysfunction or urinary urgency than tension-free vaginal tape.