Post-void residual volume \>100cc

Detrusor overactivity on preoperative multichannel urodynamic testing

History of previous synthetic, biologic or fascial sub-urethral sling

Desires future childbearing

Chronic inguinal or vulvar abscess or history of Hidradenitis Suppurativa

History of bleeding diathesis or current anti-coagulation therapy

Inguinal lymphadenopathy or inguinal/vulvar mass

Current genitourinary fistula or urethral diverticulum

Reversible cause of incontinence (i.e. drug effect)

Contraindication to surgery

Study Comparing Tension-free Vaginal Tape With the Monarc Procedure for Stress Urinary Incontinence