Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Randomized Clinical Trial of Vaginal Mesh for Prolapse
Brief Summary: The primary aim of this double-blind, randomized clinical trial (RCT) is to test the hypothesis that the addition of a standardized technique of interpositional synthetic polypropylene mesh placement improves the one-year outcome of vaginal reconstructive surgery for pelvic organ prolapse compared to traditional vaginal reconstructive surgery without mesh.


Options:
A: Inclusion Criteria:

* Women who require surgical correction for anterior compartment prolapse. (Concomitant surgery is permitted.)
* Point Ba of 0 or greater: that is a positive Ba, indicating that the prolapse is beyond the introitus, not within the vagina.
* Patient must consent to participate in the study.

Exclusion Criteria:

* Having an obliterative procedure (Lefort procedure or colpocleisis).
* Allergy to graft material.
* Immunocompromised.
* Previous anterior compartment repair.
* Are unable to understand English.
* Will be unavailable for follow-up.
B: Inclusion Criteria:

* Postmenopausal women with symptomatic anterior vaginal wall prolapse to the hymen or beyond when under strain and referred for reconstructive pelvic surgery

Exclusion Criteria:

* an apical defect indicating concomitant vaginal fixation, or stress urinary incontinence necessitating surgery, or her main symptomatic prolapse component was in the posterior vaginal wall.
C: Inclusion Criteria:

* Woman \> 21 yrs
* Stage II-IV vaginal prolapse
* Desires vaginal reconstructive surgery
* Able to complete study questionnaires and assessments
* Uterus \< 12 weeks size
* Available for 12 months follow-up

Exclusion Criteria:

* Medical contraindications, e.g. current urinary tract, vaginal or pelvic infection, history of pelvic irradiation, history of lower urinary tract malignancy, chronic steroid use or a compromised immune system.
* Current intermittent catheterization.
* Pregnancy or desire for future fertility.
* Presence of an adnexal mass.
* Shortened vagina or other known Mullerian anomaly (e.g. uterine didelphys).
* Other laparoscopic or abdominal/pelvic surgery in the past 3 months.
* Known neurologic or medical condition affecting bladder function, e.g. Multiple Sclerosis, spinal cord injury.
* Need for concomitant surgery requiring an abdominal incision.
* \< 12 months post-partum.
* Non-english speaking
D: Inclusion Criteria:

* recurrent anterior and/or posterior prolapse POP-Q stage 2 or more
* patient has agreed to undergo implantation of TVM (prolift) or fascial plication
* patient is willing to return for follow-up evaluation at 6 weeks, 6 months and 12 months
* patient is willing to complete quality of life questionnaires at 6 and 12 months

Exclusion Criteria:

* patient is or wants to become pregnant
* patient has had previous synthetic mesh procedure (a previous mid-urethral sling procedure is NOT an exclusion criterion)
* patient has current urinary tract or vaginal infections
* patient has a blood coagulation disorder
* patient has a compromised immune system or any other condition that would compromise healing
* patient has renal insufficiency and/or upper urinary tract obstruction
* patient is unwilling or unable to return for evaluation
* patient has had previous irradiation
* patient has any malignancy
* patient has large ovarian cysts of large myoma

Answer: C