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.