Butters 2007.

Methods	Single centre, three arms RCT ‐ Conparisons: Shouldice vs Lichtenstein vs TAPP (not considered). Randomization: generation of sequence not stated, Allocation concealment using sealed envelopes. Maximum follow up: 52 months. Exclusion after randomizations: no. Losses to follow up: Shouldice 19, Lichtenstein 17 (9 deaths, 5 moved to other places and 22 refused to continue). Analyses by protocol
Participants	Country: Germany. Setting: centre specialized in hernia repair. Total enrolled patients: 186 (93 Shouldice vs 93 Lichtenstein). Mean age: Shouldice: 53; Lichtenstein 56. Gender: 186 M. Inclusion criteria: age >18, primary inguinal hernia, elective repair. Exclusion criteria: no known. Demographic and baseline data reported: comparability for age, type of hernia.
Interventions	Shouldice (n=93). Technical notes not specified. Lictenstein standard (n=93).
Outcomes	Recurrence (definition of recurrence not reported). Chronic pain (data from Koninger 2004). Postoperative satisfaction level Testicular atrophy
Notes	52 months follow up assessed by a resident surgeon by physical examination in 150 patients (80.6%) Conflict of interest: not reported. Sources of funding: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Allocation concealment (selection bias)	Low risk	A ‐ Adequate