Using 2-0 Vicral sutures on 5-8 circle tapered needles, full thickness sutures are placed at 12, 3, 6, and 9 o'clock positions through the urethral mucosa, smooth muscle, striated urethral sphincter, and fascia. At the 6 o'clock position the suture is placed with care to avoid injuring the neurovascular bundles, which are located posterior to the striated sphincter. At the 12 o'clock position the suture incorporates the anterior dorsal vein/striated urethra sphincter hood.