Introduction
There is international controversy regarding the use of mid-urethral slings (MUS) as evidenced by the July 2020 Baroness Cumberledge inquiry in the United Kingdom which stated that: “little is known about the nature and extent of mesh complications”, “every effort should be made to obtain sufficient data” and that “few long-term studies exist”1. National and international organisations and a Cochrane review have also called for more long-term data2,3,4,5,6.
The MONARCTM trial, which was a non-inferiority multi-centre randomised controlled trial comparing the retropubic (TVT) and transobturator tape (TOT) procedures was undertaken 12 years ago7 and provides an opportunity to address some of the issues above. At 12 months 65.5% of participants in the TVT group and 63.4% in the TOT group had no SUI7. This follow up study compares the long-term efficacy, patient satisfaction, complications and re-operation rates associated with the MUS in this same patient group using the same patient reported outcome measures (PROM’s) as in the original study.