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To report the medium term effects of the pubovaginal sling (PVS) on patient quality of life (QOL). Patients and Methods Over a two year period, 72 females aged between 17 and 63 years (mean 46.1 years) underwent PVS for urodynamic stress incontinence (USI). All data were accrued prospectively. Preoperative assessment consisted of a full history (including King's Health and SF-36 questionnaires), physical examination, urinalysis and urodynamics. Postoperatively all patients were assessed at 6 weeks and 6 months. At these intervals each patient was questioned regarding persistence or recurrence of USI, presence of urge/urge incontinence (UI) and QOL. Preoperatively, 60 patients (83.3%) demonstrated type II USI and 12 (16.7%) had type III USI. Detrusor overactivity (DO) was also present in 3 patients. At 6 weeks 100% of patients remained completely dry, 8 (11%) patients complained of urgency but none complained of UI. At 6 months 95% of the subjects remained dry, 3 complained of recurrent USI, 7 complained of urgency and 1 of UI. The incidence of de novo urgency was 5.5%. There were significant improvements in 4 of the 8 domains of the SF-36, and in 8 of the 9 domains of the King's Health questionnaire, at both 6 weeks and 6 months follow-up. PVS is effective in the treatment of all types of USI, with early success rates of up to 95%. The procedure is associated with minimal morbidity and has a positive impact on patient QOL.