I appreciate the comments made by Wael Agur regarding colposuspension compared with slings. His argument against Fusco et al.’s conclusion that synthetic slings were superior to colposuspension is strong. However, Fusco and Novara [
1] corrected their meta-analysis and placed the Valpas study in the laparoscopic colposuspension group. The corrected Forest plot did not change the odds ratio and
p value compared with the original plot. The other problem with meta-analysis studies is the inclusion of nonhomogenous groups and different surgical techniques. Autologous slings from different body sites (e.g., fascia lata or vaginal wall) can show great variation in their viscoelastic properties and remodeling after grafting. …