The purpose of this report is to present a personal experience, with an up to 16-year follow-up, in the management of stress urinary incontinence using a retropubic cystourethropexy. An attempt is made to prove that, in addition to the standard Kelly anterior colporrhaphy, a transvaginal retropubic cystourethropexy helps to improve long-term results. Also, the results of transvaginal retropubic cystourethropexy (modified Pereyra procedure) and abdominal retropubic cystourethropexy (modified Marshall- Marchetti-Krantz procedure) are reviewed. Two hundred fifty-two patients received a modified Pereyra procedure and 490 patients underwent a modified Marshall-Marchetti- Krantz procedure in a 17-year period. The final corrected results of both of these procedures indicate that the percentage of patients clinically cured are almost identical (937c). Thus, for the treatment of genuine stress urinary incontinence, either the modified Pereyra procedure plus anterior colporrhaphy or the Marshall-Marchetti-Krantz procedure can be used with almost identical results. The route of the procedure performed, either abdominally or vaginally, is often determined by associated findings.