In a prospective long-term follow-up study we evaluated the results of TVT surgery in 34 women with recurrent stress urinary incontinence in whom previous traditional surgical procedures had failed. The women were followed for a mean of 4 years (range 3-5) after TVT surgery. The mean age was 58.9 +/- 10 years and the mean parity 2 (0-4). Pre- and postoperative evaluation was performed according to a protocol which included gynecologic examination, urodynamic investigations, quality of life evaluation and 24-hour pad test. According to the protocol 28 patients (82%) were cured, 3 (9%) were significantly improved, and the operation failed in 3 cases (9%). There were no significant intra- or postoperative complications. All patients were operated on under local anesthesia with a short hospitalization and had no long-term postoperative voiding problems.