The invention provides a driver (70) and methods for advancing needles, cannulas (90), and other medical devices through the pubic bone (45). The driver (70) may be used in connection with a driver frame assembly (100) for proper positioning and stabilization of the driver (70), and with other devices for creating a cavity in the urethral floor and for positioning medical devices therein. The invention also provides simple connections (126) for attaching a suture (88) to a device within the cavity in the urethral floor or in the vagina (4), and also for attaching sutures (88) to the pubic bone (45).