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Monarc™ Subfascial Hammock

The Monarc Subfascial Hammock™ is a minimally invasive treatment option for female patients suffering from stress urinary incontinence (SUI). Monarc's transobturator approach and proven, Type 1 polypropylene mesh create a hammock-shaped midurethral sling that treats SUI by supporting the urethra during times of increased abdominal pressure, such as sneezing, coughing or laughing. Monarc's efficacy has been proven in multiple clinical trials and its outside-to-in transobturator approach avoids the retropubic space, reducing the potential for serious complications.

Features & Benefits

The Needles

The Monarc™ Subfascial Hammock is a single-use procedure kit that includes two stainless steel needles each specifically designed for right-side/left-side. The needles are designed to move away from the obturator canal, avoid the retropubic space and minimize blind needle passage.

The Monarc TOS series allows physicians to select from three needle types to better accommodate individual patient anatomy:

  • Standard Monarc - Tight, centered helical passer for small to medium or large patients
  • Monarc+ - Wide, centered helical passer for larger patients
  • Monarc C - Passer for physicians who prefer the C shape

For a complete list of warnings and precautions please review Safety Information.

The Mesh

Monarc's proven Type 1 polypropylene mesh offers tissue fixation without suturing and large pores to facilitate tissue integration. The patented tensioning suture maintains mesh integrity during placement and allows for intra and immediate post-operative tensioning while reducing sling deformation.


The Monarc procedure uses an innovative transobturator approach that avoids the retropubic space and creates a restorative hammock that mimicks the patient's natural anatomy. With a transobturator approach, cystoscopy can be performed at the physician's discretion.

The Monarc procedure offers many benefits:

  • Proven efficacy and safety
  • Minimally invasive, quick procedure performed in under 15 minutes
  • Incision sites in the vagina and femoral/pelvic fold are small
  • Appropriate for patients who have retropubic scarring
  • Outside-to-in approach moves needles away from dangerous vessels and nerves
  • Needles are designed to facilitate accurate needle placement and minimize "blind" needle pass
  • Mesh is attached to the needle passers with secure locking connectors
  • Resorbable tensioning suture maintains mesh and enables fine adjustments in mesh tension during the procedure and in the immediate postoperative period
  • Can be used with local, spinal or general anesthesida

After the procedure, most patients experience immediate continence.

600012-01A (12/07)