Title: Quality of life and its associated factors among women with pelvic organ prolapse who
attend gynecology clinics Southern Ethiopia 2022
Version: 3 Date: 21 Feb 2024
Reviewer's report:
General comment:  I am happy with the title, the authors address the area that needs evidence
for effective implementation in the context, where the magnitude of the problem is high. Many
women suffer from POP a life-threatening disorder that affects quality of life. The authors used
standard tools for the measurement of quality of life, however, the standard measurement of
social support is not explained
Specific comment
Background
Line 34 POP use of abbreviation at the beginning of sentences not recommended the need to
use the full word, similar comment in the document
Line 31; good if the second sentences come first then the first statement line 30 follows,
Background
Mixing of ideas on the magnitude, impact, and factors associated with the paragraph needs to
be updated in logical flow by separating paragraphs, avoiding repeating words or sentences, and
clearing gaps that need clarification
Line 89-91 why is comorbidity excluded? Need explanation, because comorbidity is one
predictor variable in the document
Line 95-98 poor P-QOL is an instrument used to measure the quality of life how the authors
consider it as an assumption for sample size determination needs an explanation
Figure 1 line 130 the abbreviation of the health facilities should be in full name at the footnote
of the figure
Line 140-150 says “QOL among women with POP was evaluated using the quality of life
measurement tool validated in Ethiopia, after translating into the Amharic language” How about
the participant non-Amharic language speaker and Gurage language speaker?
On the Schematic presentation of the sampling procedure, 423 women, within two months (April
30 to Jun 30, 2022) visited and diagnosed as POP, what was the prevalence of POP in the area
or country? How were these numbers diagnosed? This needs explanation
How systematic sampling technique carried out in one day may be one patient or no patient
visits health facilities, needs an explanation
In the analysis plan in the methodology part, the authors categorized quality of life as good and
poor, however in the associated table (table 6) considered poor quality of life as yes or no, why?
It is good for me to present as poor and good, it can be coded for analysis in the database
Discussion
Line 293: in the study of “prolapse-related qualities of life” clarify as pelvic organ prolapse-
related quality of life, review all the document
Line 294: the word  “figure” is not an appropriate word change to the result or finding
299-301: says “In relation, this study was consistent with a study conducted in Turkey [32].
This could implicate that POP was still a public health problem that affects women's quality of
life by compromising their physical, social, and emotional well-being”, the sentences are not
logically constructed. is that the consistency with the mentioned study compromise the physical,
and social…well-being?
Comparison of the study is good if the study method, tool, and setting are similar, otherwise,
evidence-based reason needs to explain
On the mentioned reason for the difference in finding, study design may not affect the prevalence
study check it
Conclusion
Studying in a gurage zone may not be representative of the country, recommendations should
to for the study area
Line 377: “thire” may be their check it
Language edition and logical flow of sentences and paragraphs need further work