In response to our editorial in the first issue of the IUJ this year [1], Inoue et al. wrote a letter to the editor to present their outcomes from 500 tissue fixation system mini-sling operations to treat women with stress urinary incontinence (SUI). They reported that their mini-sling operation method has a 90% cure rate for SUI and no erosions after 3 years’ follow-up as well as 90.0% cure for treating women with intrinsic sphincter defect after 1-year follow-up. Obviously, their mini-sling operation method had excellent success rates and fewer intra- and postoperative complications.

In our editorial, we highlighted that less pain and fewer postoperative complications, minimal invasiveness and reduced complications from the artificial material implant will be trends for treating stress urinary incontinence in the future. Whether the mini-sling will become the new gold standard for anti-incontinence surgery remains to be clarified by large-scale studies with long-term follow-up periods. In the letter of Inoue et al., the tissue fixation system for mini-sling operations is safe and effective. However, 3 years’ follow-up is mid-term, and their outcomes still need a longer follow-up period to prove their outcomes are durable.