I f rst encountered the Integral T eory system in the early 1990 at the Royal Perth Hospital laboratory in Western Australia where I was working on laparoscopic colposuspension. Even in prototype form, the IVS operation was so simple and ef ective that I adopted it immediately. Subsequently, based on my experiences, I wrote the following in the Medical Journal of Australia in October 1994: (the operations) promise a new era for women, virtually pain-free cure of prolapse and incontinence without catheters, and return to normal activities within days. Now, ten years later, more than 500,000 ‘tension-free’ anterior or posterior sling operations have been performed. One case in particular stands out from those early years. A woman patient in her mid-50 came to see me with a f ve year history of urinary retention which required an indwelling catheter. T is woman had consulted more than a dozen medical specialists who had told her the same story: no cure was possible. Using the Structured Assessment of the Integral T eory it was deduced that she had a posterior zone defect. I performed a Posterior IVS. T e next day the patient was voiding spontaneously with low residuals, and she has remained well since.