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Hello Richard,   You ask good questions. Please see this article by Dr. Sobol:   A New Treatment for Male Stress Incontinence http://www.healthcentral.com/incontinence/c/52/12893/male-stress   In particular, note where she writes:   "Following suit with the minimally invasive type of slings that women have been able to enjoy recently, there is now the trans-obturator sling for men. The incision is similar to that for the older sling but the procedure involves only placing a mesh-like material against the urethra to increase resistance. The complication rate is pretty low, and the procedure itself is easier for the surgeon. The results are comparable or better to the older sling that used bone anchors."   I hope this is helpful to you.   Best, Maria