Al‐Nazer 2007

Methods	Single‐centre RCT for stage 2 POPQ prolapse PC‐generated randomisation 2‐year follow‐up No CONSORT statement Blinding not stated Authors state power of 85% need sample size of 20 in each arm
Participants	40 randomised in abstract, however 44 were randomised, 4 of whom failed to return postoperatively and were excluded Inclusion criteria: stage 2 POPQ cystocele with no plans of pregnancy in 12 months Exclusion criteria: contemplating pregnancy, women with paravaginal defects, needing continence surgery, prior colposuspension or vaginal surgery, immunocompromised, or diabetics
Interventions	A (n = 23): anterior colporrhaphy AC 0 polyglactin (Vicryl) suture B (n = 21): self styled armless soft polypropylene (Gynemesh) mesh without AC
Outcomes	Assessed at 6 weeks, 3 months, then every 6 months to 2 years postop Reports the following review outcomes: Awareness of prolapse (subjective persistence of symptom vaginal bulge) Recurrent prolapse at 1 to 3 years Mesh erosion Bladder injury (cystotomy) Objective failure rate stage 2 POPQ at Aa, Ba, Ap, or Bp Bladder function (de novo SUI) Sexual function (de novo dyspareunia) Quality of life: PQOL questionnaire; change scores Hospital stay Operating time
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer‐generated number tables
Allocation concealment (selection bias)	Unclear risk	Sealed envelopes to ensure allocation concealment; as not consecutive sealed, opaque envelopes unclear
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Not stated
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Reviewers blinded except when mesh exposure occurred
Incomplete outcome data (attrition bias) All outcomes	Low risk	At 1‐year, group A 20/23, group B 20/21
Selective reporting (reporting bias)	Low risk	Reports main review outcomes
Other bias	Unclear risk	Funding not stated; authors no COI