An implant or sling device is provided with a tension adjustment system. The adjustment system can include one or more small pressure bulbs placed against the inferior pubic rami for support. By palpating the bulbs (one on left and one on right), the pressure can be adjusted to control the tension of the implant. Other conduits, balloons, introduction tools, ports and fluid adjustment components and mechanisms can be included to provide selective adjustment of the tension of the implant relative to the supported tissue or organ.