Cheung 2016.

Study characteristics
Methods	Design: parallel group RCT Dates study conducted: December 2011 to November 2014
Participants	Setting: Hong Kong, single centre Number of participants: 276 women with pelvic organ prolapse stages I to III (POPQ) Mean age: PFMT group 62.7 (SD 10.2); pessary group 62.5 (SD 9.1) Prolapse staging: PFMT group: stage I n = 14 (10%); stage II n = 92 (67%); stage III n = 31 (23%) Pessary group: stage I n = 11 (8%), stage II n = 96 (69%) stage III n = 32 (23%) Prolapse compartment: PFMT group: anterior n = 91 (61.4%); apical n = 38 (27.7%); posterior n = 8 (5.8%) Pessary group: anterior n = 90 (64.7%); apical n = 45 (32.4%); posterior n = 4 (2.9%) Inclusion criteria: symptomatic pelvic organ prolapse stage I to III (POP‐Q), no previous treatment Exclusion criteria: complications that arise from prolapse, confirmed urinary retention, vaginal erosion or ulcer that required active treatment, impaired mobility, cognitive impairment, language barrier that prevented questionnaire completion
Interventions	Group I (n = 137): PFMT treatment alone Group II (n = 139): vaginal ring pessary plus conservative treatment
Outcomes	Primary outcome: PFDI and PFIQ plus subscales Secondary outcome: discomfort from prolapse symptoms (VAS score), desired treatment, complications
Notes	Funding source: not reported Declarations of interest: quote: "The authors did not report any potential conflicts of interest"
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Women randomised using random computer‐generated numbers and allocated in serially numbered envelopes.
Allocation concealment (selection bias)	Low risk	Allocated by random number series
Blinding of participants and personnel (performance bias) All outcomes	High risk	Participants not blinded to treatment. Investigator who took history and recorded POP‐Q blinded to group allocation.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Primary outcome self‐completion. Investigator who took history and recorded POP‐Q blinded to group allocation.
Incomplete outcome data (attrition bias) All outcomes	Low risk	135/139 in pessary group and 130/137 in PFMT alone group completed measures at 12 months.
Selective reporting (reporting bias)	Low risk	Not all outcomes listed in Trial registry and paper presented but main outcomes are presented and they have reported outcomes of interest to this review
Other bias	Low risk	None.