Objective: Determination of the short term safety, efficacy and urodynamic effect of the use ofProlene mesh as a midurethral sling for surgical correction of female stress urinaryincontinence using trans-obturator vaginal tape inside -out technique as a low cost alternativefor available commercial kits in the treatment of female stress urinary incontinence.Patients and Methods: Since June 2006, thirty female patients with stress urinaryincontinence (9 with pure ISD (30%), 18 with urethral hypermobility (60%) & 3 (10%) withcombined ISD & hypermobility) underwent Prolene mesh midurethral sling in our institution.Preoperative evaluation consisted of history, examination, ultrasonography, ascendingcystography, urodynamic studies, and routine labo ratory investigations. SUI was evidentclinically in all patients. 2 patients underwent anterior colporrhaphy concomitant to the Prolenemesh procedure for correction of symptomatic grade II cystocele. Prolene mesh was cut into atapes measuring 10x1.5 cm and sterilized by autoclave. The mesh was placed at the mid -urethra and passed through the obturator foramen a by Prolene sutures loaded on speciallydesigned helical passers. The helical passers were passed inside -out. The prolene sutures wereanchored to the subcutaneous tissue at the site of exit. Patients were followed up (for a mean of9 months) by history, examination, urine analysis, pelvic ultrasound to detect residual urine,and urodynamic evaluation at 1, 3, 6, 9 & 12 months post-operatively.Results: All procedures were completed with no intraoperative complications, no failures orrecurrences of stress incontinence. All patients were objectively cured but twenty nine patientswere subjectively cured (96.7%). One patient (3.3%) developed obstruction but she couldcomplete her voiding without residual urine . She was satisfied with her results. 3 patients(10%) developed vaginal infection, one patient (3.3%) developed wound infection, twopatients (6.7%) developed UTI & one patient complained from dy spareunia. Lower limb &groin pain has been developed in 15 patients (50%), but was controlled by analgesics and hasdisappeared in all patients within the 1st post-operative month. Subcutaneous non absorbablesutures were felt in one patient. De novo urgency and erosions have not occurred in anypatient.Conclusion: Results of our technique showed that midurethral trans-obturator prolene meshsling is safe, efficient, reproducible and a low cost technique for treatment of stress urinaryincontinence. Our technique does not require disposable instrumentation for placement, and isinexpensive as our modified helical passers have the advantage of being resterilizable & eachProlene strip will cost less than 10 EGP. The price of similar incontinence kits in the marketranges from (3000 − 3500 EGP) per set. Long term follow up is required together withprospective randomized studies with the original TVT -O technique to confirm these results.