Treatment Overview
The Monarc™ Transobturator Sling System is a leading surgical treatment for stress urinary incontinence (SUI) in women, developed by American Medical Systems (AMS). It is designed to provide tension-free support to the mid-urethra using a soft, biocompatible polypropylene mesh placed via the transobturator (TOT) route, which passes through the obturator foramen instead of behind the pubic bone.
This approach minimizes surgical trauma and significantly reduces the risk of complications seen in retropubic sling techniques. In Korea, the Monarc™ System is widely used in top uro-gynecology and pelvic-floor centers, where highly skilled surgeons employ 3D endoscopic visualization, micro-tension control systems, and robotic precision to ensure accurate placement, rapid recovery, and long-lasting continence results.
Purpose & Benefits
Purpose:
- To treat stress urinary incontinence caused by weakened pelvic-floor muscles or urethral hypermobility.
- To restore normal urethral support and prevent urine leakage during physical exertion, coughing, or sneezing.
- To offer a safe, minimally invasive alternative to retropubic sling surgery.
Benefits:
- Transobturator approach avoids the retropubic space, reducing risks of bladder or bowel injury.
- Short surgical time (approximately 20–30 minutes).
- Less postoperative pain and faster healing than traditional methods.
- Tension-free mid-urethral support allows natural voiding and comfort.
- High success rate (85–95%) with excellent long-term durability.
- Korean clinics enhance this with real-time imaging, micro-tension feedback, and custom-tailored anatomical placement.
Ideal Candidates
The Monarc™ Transobturator Sling System is ideal for:
- Women with mild to moderate stress urinary incontinence.
- Patients with urethral hypermobility but preserved sphincter function.
- Postpartum women with pelvic-floor weakening and mild incontinence.
- Patients seeking a less invasive, quick-recovery surgery with minimal scarring.
- Women unresponsive to conservative treatments such as pelvic exercises, EMS therapy, or laser rejuvenation.
Not suitable for:
- Severe intrinsic sphincter deficiency (ISD).
- Patients with active urinary or pelvic infections.
- Individuals with advanced pelvic-organ prolapse requiring multi-compartment repair.
Possible Risks & Complications
Although the Monarc™ Sling System is very safe and well-established, potential risks may include:
- Temporary urinary retention or difficulty voiding.
- Minor vaginal bleeding, bruising, or tenderness.
- Groin or thigh discomfort (typically mild and short-lived).
- Rare mesh exposure or erosion.
- Transient urinary urgency or frequency.
In Korea, such risks are minimized through ultra-precise surgical techniques, high-definition imaging, and the use of refined mesh materials designed for biocompatibility and flexibility.
Surgical Techniques Used
Korean uro-gynecologic surgeons perform Monarc™ Sling Surgery using advanced minimally invasive techniques and enhanced visual guidance to ensure precision and safety.
Procedure Steps:
- A small incision (1–1.5 cm) is made beneath the mid-urethra in the vaginal wall.
- Two tiny punctures are made in the inner thighs at the groin level.
- The Monarc™ sling is inserted through the obturator foramen using curved introducer needles (the “outside-in” technique).
- The sling is positioned tension-free beneath the urethra to support natural closure during exertion.
- The excess mesh is trimmed, and the incisions are closed with absorbable sutures.
Korean Surgical Advancements Include:
- 3D endoscopic guidance for real-time visualization.
- Micro-tension adjustment systems to prevent over-tightening.
- Soft, monofilament mesh optimized for Korean pelvic anatomy.
- Robotic-assisted precision in complex or recurrent cases.
- Integration with pelvic rehabilitation therapies for enhanced recovery.
Common Techniques in Korea:
- Outside-In Transobturator Approach (Standard): Preferred for most patients; ensures stable urethral support.
- Inside-Out Approach (Modified): Minimizes tissue disruption and postoperative discomfort.
- Hybrid Monarc™ Procedures: Combine sling placement with vaginal rejuvenation or HIFU tightening for both functional and aesthetic results.
Recovery & Aftercare
Recovery:
- Outpatient or same-day discharge procedure.
- Mild groin or vaginal discomfort for 1–2 days.
- Return to daily light activities within 2–3 days; full recovery within 4–6 weeks.
Aftercare:
- Avoid strenuous activity, sexual intercourse, and heavy lifting for 6 weeks.
- Maintain hydration and proper hygiene.
- Avoid constipation to prevent pelvic strain.
- Follow up at 1 week, 1 month, and 3 months to monitor sling placement and continence.
- Korean clinics often include pelvic-floor physiotherapy, EMS, or biofeedback programs to reinforce continence and strengthen pelvic muscles.
Results & Longevity
Results:
- Immediate or rapid improvement in urinary control.
- Significant reduction or elimination of urine leakage during exertion.
- Natural urination maintained without obstruction.
- Improved pelvic-floor support and overall quality of life.
Longevity:
- Long-lasting results—typically 10–15 years or more.
- Very low recurrence rates due to high-quality mesh materials and precise Korean surgical technique.
- Maintenance pelvic exercises or periodic EMS therapy can further extend results.
Treatment Process in Korea
Why Korea is a Top Destination:
- Korea is a global leader in pelvic-floor and uro-gynecologic surgery, with advanced medical technology and top-tier surgeons.
- Korean hospitals use the latest AMS Monarc™ systems with integrated 3D imaging and micro-tension calibration.
- Comprehensive care combines functional, aesthetic, and rehabilitative medicine.
- International medical services with bilingual staff ensure seamless patient experiences.
- Exceptional surgical precision, fast recovery, and low complication rates make Korea one of the most trusted destinations for sling surgery.
Typical Procedure Flow:
- Consultation: Pelvic-floor evaluation, urodynamic studies, and ultrasound imaging.
- Preoperative Planning: Selection of the appropriate sling route and tension adjustment strategy.
- Anesthesia: Local, spinal, or light general anesthesia.
- Sling Placement: Monarc™ mesh inserted through the obturator route under endoscopic guidance.
- Verification: Endoscopic inspection ensures proper sling positioning and bladder safety.
- Closure: Minimal suturing using absorbable materials.
- Postoperative Observation: Short monitoring period; patients often discharged within hours.
- Follow-Up: Regular checkups at 1 week, 1 month, and 3 months for optimal healing and continence assessment.
Unique Korean Innovations:
- 3D pelvic mapping for custom sling tensioning.
- Robotic micro-guidance systems for unmatched surgical accuracy.
- Ultra-soft, biocompatible Monarc™ mesh adapted for comfort and flexibility.
- Hybrid pelvic recovery programs combining surgery, EMS therapy, and rejuvenation.
- Aesthetic micro-suturing techniques ensuring no visible scars and faster healing.
Cost Range (Details)
The cost of Monarc™ Transobturator Sling Surgery in Korea depends on hospital type, surgeon expertise, and aftercare options:
- Standard Monarc™ Sling Procedure: ₩ 4,000,000 – 6,000,000 KRW (≈ US $3,000 – $4,600)
- Advanced Inside-Out or Hybrid Monarc™ Technique: ₩ 6,000,000 – 8,000,000 KRW (≈ US $4,600 – $6,100)
- Comprehensive Pelvic Rehabilitation Package: ₩ 8,000,000 – 10,000,000 KRW (≈ US $6,100 – $7,600)
- Robotic-Assisted or Premium Hybrid Programs: ₩ 10,000,000 – 12,000,000 KRW (≈ US $7,600 – $9,100)
Korean medical centers offer world-class surgical precision, excellent outcomes, and holistic recovery programs at globally competitive prices, making this procedure a cost-effective and safe option for patients worldwide.
Popular Clinics in Korea
- University-affiliated women’s hospitals specializing in pelvic-floor and incontinence surgeries.
- Gangnam uro-gynecology centers offering Monarc™ and other transobturator sling systems.
- Women-exclusive hospitals combining continence repair with vaginal rejuvenation.
- Postpartum pelvic rehabilitation centers focusing on pelvic muscle recovery and strengthening.
- International medical centers providing comprehensive and bilingual patient care.
