In this proposed study, the investigators aim to evaluate a modified suture urethropexy technique for the treatment of female stress urinary incontinence.

Participants will be followed with postoperative visits after 2 weeks, 2 months, and 12 months. Pelvic floor ultrasound imaging will be performed before surgery and after 2 months and 12 months, to evaluate urethral mobility.

This study is designed as a prospective observational study. The hypothesis is that suture urethropexy will improve stress urinary incontinence symptoms in participants with stress urinary incontinence and normal urethral closure pressure at 2 months and 12 months after surgery.

Specific Aims:

Aim 1: Investigate the efficacy of this mesh-free suture based surgical technique for improving SUI symptoms

Aim 2: Investigate the efficacy of this mesh-free suture based surgical technique on key urethral support defects observed with 3D ultrasound

Inclusion Criteria:

• 18 years or older with stress dominant urinary incontinence
• Stress urinary incontinence confirmed by testing (e.g. urodynamics)
• Able to provide informed consent and attend post-operative visits

Exclusion Criteria:

• Detrusor overactivity (> 40cm H2O)
• Maximum Urethral Closure Pressure (< 40 cm H2O)
• Post void residual > 150 mL
• Prior surgery for stress urinary incontinence with retained material (e.g. bulking agent, sling)

Participants with female pelvic anatomy, 18 years or older, with stress dominant urinary incontinence interested and eligible for surgical treatment