Carey 2009

Methods	Single‐centre RCT CONSORT: no Randomisation: computer generated Allocation concealment: N/S Women, surgeons, and reviewers not blinded 12 months' follow‐up
Participants	Inclusion criteria: women who were recommended vaginal surgery for anterior and posterior compartment with ≥ grade 2 prolapse Exclusion criteria: only requiring anterior or posterior compartment surgery, apical prolapse beyond the hymen, or those requiring abdominal mesh surgery Randomised: 139 (A 70, B 69); 10 women breached study protocol, and 11 more recruited. All were analysed Lost to follow‐up: A 6, B 9 Analysed 12 months:  A 63, B 61
Interventions	A (70): traditional anterior and posterior fascial plication using polydioxanone sutures B (69): anterior and posterior repair with Gynemesh PS augmentation
Outcomes	Assessed at 6 months and 1 year postop Reports the following review outcomes at 1 year: Awareness of prolapse Recurrent prolapse Mesh erosion Objective failure of anterior compartment Sexual function: new dyspareunia
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer generated
Allocation concealment (selection bias)	Unclear risk	Not stated
Blinding of participants and personnel (performance bias) All outcomes	High risk	No blinding
Blinding of outcome assessment (detection bias) All outcomes	High risk	No blinding
Incomplete outcome data (attrition bias) All outcomes	Low risk	Native tissue 63/70; mesh 63/69 1 year
Selective reporting (reporting bias)	Low risk	Reports main review outcomes
Other bias	High risk	Funding not stated: authors' conflict of interest financial agreement with Ethicon manufacturer of product evaluated in study