The work of Hodgkinson and Green, fortified by Shingleton and others, has brought about an era of high-grade selectivity in procedure never before available to patients undergoing operation for stress incontinence. The ability to select a procedure presupposes a basic understanding of the pathologic processes at work, and it follows that the chosen procedure must be capable of reversing the known pathologic processes, preferably in a progressive stepwise fashion. Of all the procedures designed during the distant or recent past, only the modern Kelly plication and retropubic plication of Ball, together known as the Ball combined procedure, offer true correctional capability with regard to the pathologic anatomy of stress urinary incontinence.