Treatment Overview
The Monarc Transobturator Sling Procedure is a modern, minimally invasive surgical treatment designed to correct stress urinary incontinence (SUI) by supporting the urethra with a specially engineered sling. This technique uses the transobturator (TOT) route, in which the sling is passed through small incisions in the groin rather than behind the pubic bone.
This approach minimizes complications, reduces postoperative pain, and provides a natural “hammock” of support under the urethra to prevent urinary leakage during physical activity.
In Korea, the Monarc TOT system is performed by highly skilled uro-gynecologic surgeons using endoscopic guidance and precision instruments, delivering world-class outcomes with minimal downtime, scarring, or discomfort.
Purpose & Benefits
Purpose:
- To restore bladder and urethral support for women with stress urinary incontinence.
- To prevent urinary leakage triggered by coughing, sneezing, or exercise.
- To provide a safe, mesh-based alternative to open bladder suspension surgery.
- To offer a fast, minimally invasive continence solution with minimal risk.
Benefits:
- Very small incisions and short surgery time (20–30 minutes).
- Minimal pain and rapid return to daily life.
- High success rate (85–95%) in restoring continence.
- Lower risk of bladder or bowel injury compared to retropubic sling surgeries.
- Minimal scarring and excellent cosmetic outcome.
- In Korea, enhanced with high-resolution endoscopic technology and refined tension-free placement methods for better accuracy and comfort.
Ideal Candidates
The Monarc Transobturator Sling Procedure is ideal for:
- Women with mild to moderate stress urinary incontinence.
- Patients with urethral hypermobility or weak pelvic-floor support.
- Women seeking a low-risk, minimally invasive surgery with fast recovery.
- Postpartum or menopausal women with urinary leakage during physical exertion.
- Patients unresponsive to non-surgical treatments such as Kegel exercises or laser tightening.
- Individuals with no active infection or severe prolapse.
Not suitable for:
- Women with intrinsic sphincter deficiency (ISD) needing a different type of sling.
- Patients with prior mesh-related complications or severe pelvic scarring.
Possible Risks & Complications
The Monarc TOT procedure is considered safe and well-established, but potential risks include:
- Mild groin or thigh discomfort for a few days.
- Temporary difficulty urinating or mild urinary retention.
- Minor vaginal or incision site bleeding.
- Rare mesh-related complications such as exposure or erosion (extremely uncommon with modern Korean mesh).
- Infection (minimized through sterile surgical environments).
- Very rare injury to urethra or bladder (checked intraoperatively via cystoscopy).
Korean surgeons use biocompatible, lightweight polypropylene mesh and ultra-precise insertion techniques to virtually eliminate these risks.
Surgical Techniques Used
Korea’s uro-gynecologic centers utilize advanced Monarc TOT systems for precise, minimally invasive sling placement.
Procedure Steps:
- A small (1–1.5 cm) incision is made beneath the mid-urethra inside the vaginal wall.
- Two tiny incisions are made in the inner thighs near the groin.
- A specially designed Monarc sling is inserted using curved introducer needles that pass through the obturator foramen (a natural opening in the pelvic bone).
- The sling is positioned tension-free beneath the urethra, acting as a supportive hammock.
- The tension is adjusted precisely to allow normal urination while preventing leakage.
- Incisions are closed with absorbable sutures — no visible external scars.
Korean Surgical Enhancements Include:
- Endoscopic and ultrasound guidance for exact placement.
- High-precision tension adjustment to prevent postoperative retention.
- Use of ultra-soft, monofilament Monarc slings for better integration with tissue.
- Micro-suturing and refined anesthetic techniques for patient comfort.
- Hybrid approaches combining TOT with laser or EMS therapy for pelvic-floor reinforcement.
Recovery & Aftercare
Recovery:
- Outpatient or short hospital stay (same day or overnight).
- Minimal postoperative pain or discomfort.
- Return to daily activities within 2–3 days; complete recovery in 4–6 weeks.
Aftercare:
- Avoid heavy lifting, sexual activity, and strenuous exercise for 4–6 weeks.
- Maintain proper hygiene to prevent infection.
- Drink fluids regularly and avoid constipation.
- Follow up at 1 week, 1 month, and 3 months post-surgery.
- Perform light pelvic-floor exercises once approved by the doctor.
- Korean hospitals often include postoperative physiotherapy and EMS programs to strengthen pelvic support and improve durability.
Results & Longevity
Results:
- Immediate improvement in bladder control for most patients.
- Elimination or significant reduction of urinary leakage during exertion.
- Natural urethral function preserved — no over-tightening or obstruction.
- Improved quality of life and self-confidence.
Longevity:
- Results are long-lasting, typically 10–15 years or more.
- Recurrence is rare when performed with proper technique and aftercare.
- Korean innovations in sling material and tension-free fixation enhance durability and safety.
- Continued pelvic-floor maintenance helps preserve results long-term.
Treatment Process in Korea
Why Korea is a Top Destination:
- Korea is world-renowned for its excellence in uro-gynecology and pelvic-floor surgery.
- Surgeons are internationally trained and experienced in Monarc and other sling systems.
- Hospitals use next-generation endoscopic systems for precision-guided sling placement.
- Seamless integration of functional, aesthetic, and rehabilitative care.
- Multilingual support for international patients and transparent package pricing.
- Focus on patient comfort, cosmetic outcomes, and long-term continence.
Typical Surgical Process:
- Consultation & Diagnosis: Pelvic examination, urodynamic testing, and ultrasound imaging.
- Anesthesia: Local or light general anesthesia based on patient preference.
- Sling Placement: Monarc sling inserted via vaginal and groin incisions under endoscopic visualization.
- Verification: Bladder checked for integrity and sling tension adjusted to ensure normal voiding.
- Closure: Minimal suturing; absorbable stitches used.
- Observation: Short monitoring period before discharge.
- Follow-Up: Regular postoperative checkups and pelvic physiotherapy if needed.
Unique Korean Methods & Technology:
- 3D pelvic mapping for customized sling positioning.
- High-definition visualization systems for intraoperative safety.
- Tension-free micro-adjustment tools to prevent voiding dysfunction.
- Combination of Monarc sling with pelvic rejuvenation therapies for optimal outcomes.
- Robotic or laparoscopic support in complex or recurrent cases.
Cost Range (Details)
The cost of Monarc Transobturator Sling Surgery in Korea varies depending on hospital type, technology used, and aftercare programs:
- Standard Monarc TOT Sling Procedure: ₩ 4,000,000 – 6,000,000 KRW (≈ US $3,000 – $4,600)
- Hybrid Monarc + Pelvic Rehabilitation: ₩ 6,000,000 – 8,000,000 KRW (≈ US $4,600 – $6,100)
- Robotic or Advanced TOT Technique: ₩ 8,000,000 – 11,000,000 KRW (≈ US $6,100 – $8,400)
- Comprehensive Pelvic Wellness Package (Diagnostics + Rehab): ₩ 9,000,000 – 13,000,000 KRW (≈ US $6,900 – $9,900)
Korean hospitals combine cutting-edge sling technology, expert surgical skill, and holistic rehabilitation care, offering outstanding quality at globally competitive prices.
Popular Clinics in Korea
- University-affiliated women’s hospitals specializing in pelvic-floor and incontinence surgery.
- Gangnam uro-gynecology centers offering Monarc, TVT, and MiniArc procedures.
- Women-only hospitals combining functional continence surgery with vaginal rejuvenation.
- Advanced pelvic rehabilitation clinics integrating EMS and biofeedback after surgery.
- International patient care hospitals providing personalized packages and multilingual support.
