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)