To the Editor: We are indebted to the authors for a thorough review of the diagnosis and treatment of stress urinary incontinence (SUI). However, we disagree with the author’s comments on singleincision midurethral slings. The study referenced by the authors on the role of single-incision midurethral slings in the treatment of SUI (Madsen et al) was a cohort study comparing the MiniArc (single-incision midurethral sling) with the ALIGN (retropubic midurethral sling). This study was not representative of all single-incision slings, which vary significantly in the robustness of their anchoring mechanisms. Also, there is inherent responder and recall bias in this type of cohort study. There are many randomized controlled trials (RCTs) (level I evidence) that have demonstrated equal efficacy when comparing single-incision midurethral slings with retropubic midurethral slings. We assert that more recent singleincision transobturator slings have evolved into devices that offer the simplicity of the earlier-developed single-incision sling and mini-slings and the durability of a standard transobturator sling without the extension of arms through the adductor muscles. A recent meta-analysis of RCTs comparing single-incision slings with standard midurethral slings for SUI has shown that, after excluding RCTs evaluating TVTSecur, there was no evidence of significant difference between single-incision midurethral slings and standard mid urethral sling in patient-reported cure rates and objective cure rates. This study also revealed significantly lower postoperative pain scores and earlier return to normal activities and work. Although long-term data are not available for “mini-slings,” a hypothesis can be formulated regarding the biological feasibility of their success based on what we already know to be true for transobturator tension-free vaginal tape. It would be difficult to postulate that the robust anchoring system of the more recent transobturator single-incision midurethral slings would not perform at least as well as the mesh arms of the transobturator tension-free vaginal tape. At the Institute for Female Pelvic Medicine and Reconstructive Surgery, we have been able to perform singleincision midurethral slings in the office setting, achieving optimal patient satisfaction and a decrease in health care costs.