This study was carried on 50 females complaining of genuine SUI, admitted to Urology Department-kasr El-Eini hospital, Cairo University in the period from July 2004 –August 2006. There were divided into 2 groups, group I, included 25 patients managed by TVT, group II, 25 patients managed by TVTO. Surgical therapy for SUI with T.V.T had a high success rate (88%), which is comparative to that of T.V.T.O (84%). Both had obstructive effects, but was more at T.V.T.O