In this study, patients who underwent tension-free vaginal tape placement (TVT) under general anesthesia, when no cough-stress test was done, were compared with those who underwent the procedure with local anesthesia in which the cough-stress test was used to aid in adjusting the sling placement. The data from a cohort of 170 women, which was established for a previous investigation, were used to retrospectively examine patient outcomes according to the method of anesthesia. Sandvik's Incontinence Severity Index (ISI), the short form of the Incontinence Impact Questionnaire (IIQ-7), and the short form of the Urogenital Distress Inventory (UDI-6) were used for outcome evaluation. These 3 questionnaires had been mailed to all subjects before their initial surgery. For this study, patients were contacted and asked to complete the forms once again to gain subjective information about surgical outcomes. The Stress Symptoms subscale of the UDI was considered the primary outcome measure. Of the 170 original patients, 11 had received regional anesthesia and were not included. One hundred four of the remaining women could be contacted and completed both sets of questionnaires. Seventy-four (46.5%) of these patients underwent TVT with general anesthesia and 85 (53.5%) had local anesthesia. The Obstructive/Discomfort Symptoms subscale of the UDI was the only individual measurement that did not show significant improvement from the preoperative score. Significant improvement in all other areas was reported by both groups. However, on some measures, women who had local anesthesia showed significantly greater improvement than those who had general anesthesia. In the UDI-Stress Symptoms subscale, improvement in the mean score was 16.6 points higher for women who had local anesthesia compared with the general anesthesia group (P = .02 for difference). The results of the ISI demonstrated greater improvement in the severity of incontinence symptoms for patients who had local versus those who had general anesthesia (P = .02). In the postoperative evaluation, patients were asked if they had undergone any corrective surgery to loosen or "take down" a tight TVT tape. No patient reported any such surgery, although investigators knew of 2 women who had a "takedown" while under their care.