A sling for supporting a urethra in a patient has characteristics for resisting pull-out, roll-over and a combination of both pull-out and roll-over. To facilitate resistance to pull-out, sling material has protuberances or serrations to resist movement once placed in the patient by the surgeon. Improved resistance to roll-over or roll-up is achieved by providing relief on the sling in areas potentially subjected to roll-over forces by endopelvic fascia. The sling may be used on female or male patients, and may be used in conjunction with a wider support portion to support a bladder and a urethra, rather than a urethra alone. The sling may also be used to support other tissues within a patient.