Tensioning of the AdVance® sling. (a) Actual surgical procedure; (b) lateral view of the bladder and the urethra with the AdVance® sling tensioned, leading to repositioning of the urethral bulb. The sling has folded on itself and acts as a support to the distal membranous (sphincteric) urethra. This leads to better luminal coaptation within the membranous urethra and an increase in functional urethral length. The arrow indicates the direction of movement when the sling was tensioned. (Image based on magnetic resonance imaging and changes in the zone of luminal coaptation based on intraoperative urethroscopy conducted by P.R.).