OBJECTIVES: Stress urinary incontinence (SUI) is associated with a hefty economic burden. Mid-urethral slings have become common surgical options for women with SUI. This study examines the costs of transobturator slings for SUI surgeries. METHODS: A model was created to estimate the budget impact to hospitals of transobturator sling surgery in women with SUI. Current practice using transobturator slings including the Monarc™ Subfascial Hammock, Obtryx® Transobturator Mid-Urethral Sling System, Aris® Transobturator Sling System, Align® TO Trans-Obturator Urethral Support System, Desara® Sling System, Gynecare TVT™ Obturator System Tension-free Support for Incontinence  and Gynecare TVT Abbrevo™ Continence System  were modeled. Four surgical complications were also considered: re-operation due to failure, revision or removal of sling, urologic complications including urinary obstruction and urinary tract infection, and pelvic complications. This model calculates the average one-year cost per patient with the use of each sling product and predicts the total budget for sling urinary incontinence surgery associated with each product based on these estimates. RESULTS: Average combined cost of the sling and for management of complications over one year ranged from $2,666 (Gynecare TVT™ Obturator) to $3,213 (Desara®) per patient. With the current market share for transobturator sling products, the expected expenditure is around $293,669 for a hypothetical surgical population of 100 patients. Sling costs account for approximately $105,526 (36%) of this cost with complications making up the remainder. While cost of Gynecare slings are not the least, increase in the share of use of these slings resulted in lowering of overall expenditure. CONCLUSIONS: This study represents the first comparative assessment of the costs of different sling options for SUI surgeries. Gynecare transobturator slings represent a sound economic choice for hospitals with an expected reduction in overall expenditure compared with others. Moreover, such reduction is obtained at the benefit of patients who experience fewer complications.