Overview
 
"Since having the Monarc™ procedure, I am free of absorbent pads, free of worrying about leaking, free to drink all the liquids I want and free to have fun again."*

Monarc™ Subfascial Hammock

The Monarc™ Subfascial Hammock treats female stress urinary incontinence by placing a narrow strip of mesh in your body to support the urethra. The Monarc uses what is called a transobturator approach to place the supportive mesh. The transobturator approach avoids the retropubic space, the area of loose connective tissue between the bladder, pubic bone and abdominal wall. With this approach, narrow mesh carriers are passed through an area near the groin at the obturator of the pubic bone. The mesh is then attached and pulled into place under the urethra.

Once placed, the hammock cradles your urethra and gives it a point of support.

Most patients are continent immediately following the procedure and can resume normal, non-strenuous activities within a few days.

Benefits

The Monarc™ System offers several benefits:

• Patients generally recover quickly and experience immediate continence.
• It is minimally invasive and suitable for a wide variety of patients.
• Incisions in the groin area are small.
• Can be used in patients who have retropubic scarring resulting from prior pelvic surgery.
• The hammock can be loosened or tightened during and immediately after the procedure.

*These comments are based on the types of experiences relayed in monitored chat rooms where patients have shared their experiences. They are not reflective of individual patients, and may not be typical for all users.

How it Works
 
In women with stress urinary incontinence, pelvic muscles and tissue have been weakened by pregnancy, childbirth, trauma, radiation, prior surgery, muscle damage or hormonal changes, causing the bladder and urethra to relax from their normal positions. The sudden, added pressure from coughing, sneezing, laughing or simple lifting can cause accidental loss of urine.

The Monarc™ System helps to correct the conditions that cause stress urinary incontinence with a mesh sling that supports the urethra. A narrow strip of polypropylene mesh is surgically placed in your body to cradle your urethra and give it a point of support. The self-fixating mesh anchors itself to tissue and muscle in the space surrounding the urethra.

The Procedure
 
Placement of the Monarc™ is a minimally invasive procedure that typically lasts less than 20 minutes under local, regional or general anesthesia, depending on what you and Dr. Huertas choose.

Before the procedure, Dr. Huertas will give you a thorough explanation of what will happen during your surgery and how to prepare for it. Dr. Huertas will also explain the procedure in more detail and fully describe the associated risks. Be sure to discuss any concerns you have with Dr. Huertas right away.

In general, placing the Monarc™ sling involves the following steps. (Dr. Huertas' method may vary slightly from this one.)

1. Two small incisions are made near the groin at the obturator of the pubic bone and one in the vagina.
2. Narrow sling carriers are passed through the groin incisions and exit through the vaginal incision.
3. The mesh is attached to the sling carriers, and placed under the urethra.
4. Sling carriers are removed.
5. Mesh tension is adjusted.
6. Incision is closed.

What to Expect After the Procedure

Dr. Huertas may insert a catheter through your urethra to drain urine from your bladder immediately after surgery. The catheter usually is removed before you leave the hospital.

If your bladder does not empty properly, you may have to use a catheter at home until normal voiding resumes. In addition, Dr. Huertas may prescribe antibiotics.

Most women see results as soon as the catheter is removed, usually within a day or two after the procedure.

Although many women have little or no pain after the procedure, Dr. Huertas may prescribe pain medication for you if needed.

Your incisions will be small and should heal quickly. For approximately four to six weeks you should avoid sexual intercourse, heavy lifting and exercise. You can return to other normal daily activities at Dr. Huertas' discretion, often within one to two weeks.

Dr. Huertas will provide you with additional information on how to care for yourself after surgery, including any other limitations to activities.

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If you would like more information about Monarc™ System Procedure or the other services offered by Dr. Huertas, please contact his office at 972-279-9000 and his capable staff will guide you through the process.  Even better, for more personalized information specific to your individual needs, contact us or call today to schedule a consultation. 

The Dallas Center for Laser Vaginal Rejuvenation
Otoniel Huertas, MD
2540 N Galloway Ave.
Bldg 3, Suite 304
Mesquite, TX  75150 
972-279-9000
Contact us or call to schedule your personal consultation.