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

Objective The 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 design A 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. Results Two 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. Conclusion Transobturator 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.