International Urogynecology Journal

, Volume 17, Issue 6, pp 566–569 | Cite as

TVT vs Monarc: a comparative study

  • Hans Peter DietzEmail author
  • Christopher Barry
  • Yik Lim
  • Ajay Rane
Original Article


Following the success of the tension-free vaginal tape (TVT), there has been considerable interest in technique modifications such as the transobturator approach for implant placement. We attempted to elucidate possible anatomical and clinical differences between the two methods in a retrospective cohort study. One hundred and fourteen women who had undergone TVT or Monarc implantation were assessed by or under the supervision of the senior author, with identical tensioning technique. They were followed up by an interview, uroflowmetry, and translabial 3D ultrasound. There were significant differences for patient satisfaction (P=0.013), subjective overall cure/improvement (P=0.0018), and the symptom of poor stream (P=0.03), all favoring the Monarc group. On imaging Monarc tapes appeared more proximal at rest (P=0.006) and Valsalva (P=0.002) and remained further from the symphysis pubis on Valsalva (P=0.01). At 9 months follow-up, there was no significant difference as regards to cure rates for stress incontinence between the two suburethral slings. Monarc tapes are located more proximally and may be less obstructive, judging from a lower incidence of symptoms of voiding dysfunction. Patient satisfaction and overall subjective cure/improvement were higher after Monarc. In summary, the Monarc is an effective TVT alternative, achieving cure of stress incontinence by similar means. It may be less obstructive, resulting in improved patient satisfaction.


Monarc Translabial ultrasound Stress incontinence Suburethral slings Tension-free vaginal tape 


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Copyright information

© International Urogynecology Journal 2006

Authors and Affiliations

  • Hans Peter Dietz
    • 1
    Email author
  • Christopher Barry
    • 2
  • Yik Lim
    • 3
  • Ajay Rane
    • 2
  1. 1.Department of Obstetrics and Gynaecology, Western Clinical School, Nepean CampusUniversity of Sydney, Nepean HospitalSydneyAustralia
  2. 2.Department of Obstetrics and GynaecologyJames Cook UniversityTownsvilleAustralia
  3. 3.Department of Obstetrics and GynaecologyTownsville HospitalTownsvilleAustralia

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