A method for the operative treatment of stress incontinence in the female is described. The anatomical importance of the levator sling behind the urethra is stressed. The pubococcygeal muscles which have been lateralized by trauma are prepared. The levator ani muscle with its fascia is mobilized and the two muscle components of the perineal muscles are joined in the midline. The muscular adaptation starts behind the symphysis and is carried on dorsally as far as necessary. In this way a strong sub-urethral and subvesical muscular plate is created. In 673 patients who were treated by this method recurrence was rare. A concomitant six weeks. Urodynamic studies and physical measurements showed the pivotal importance of the levator ani muscle for the maintenance of continence.