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Since its FDA approval in 2004, synthetic vaginal mesh has been used widely to improve long-term success rates of surgery for pelvic organ prolapse. However, the risks and benefits of vaginal mesh have not been clearly defined. In a double-blind trial conducted at three U.S. sites, 65 women (mean age, 64) with stage 2–4 uterovaginal or vaginal prolapse who sought reconstructive surgery were randomized to undergo vaginal repair with or without polypropylene mesh. Surgeons were fellowship-trained urogynecologists; outcomes were assessed by clinicians who were blinded to the procedure. The primary outcome (treatment success as defined by postoperative prolapse of stage 1 or lower) was determined objectively by degree of vaginal descent relativ…