Reviewer’s report
Title: 
Pelvic organ prolapse and uterine preservation: A cohort study (POP-UP
study)
Version: 
1 
Date: 
15 Dec 2020
Reviewer's report:
Thank you to the authors for their study. My line references refer to the tracked
changes copy of the manuscript.
Abstract: 
1) As in the manuscript, please do not list the shorter operative time and blood
loss as differences between your main groups or at least that these were
statistically significant. This was not statistically significant between the uterine
sparing and hysterectomy groups (p=0.05, the defined cut off for your study).
The differences between the two other groups should only be listed if you define
this subgroup comparison in your planned methods within the abstract.
Figure 1:
1) Consider clearly showing in this flowchart that the LSCH+LSC and
TLH+LSC group are one group for your primary outcome.
Tables
1) The titles of the tables need to reflect that these are not cases/controls but
instead cohorts.
2) Table 3: "C1-C7" --> this is unclear to most readers. 
Consider eliminating this
and keeping it just "mesh complication".
3) Table 3: There is a large amount of data Table 3 not reported in detail within
the manuscript's main text. 
Consider moving these to supplemental tables. and
keeping the main tables more simple.
4) Table 3: Recommend moving the mesh imaging information to its own table
for clarity. 
This will need referenced separately in the manuscript as well.
5) Table 2: There is a type of a comma instead of a period before "566" in table
2 in the p value for Clavien-Dindo complications.
Introduction:
1) Line 64-66: This final line about posterior POP is incomplete. Recommend
addending it to the previous sentence or eliminating the word "while."
2) Line 92: "Furthermore, there seems to be AN..." -- "an" is missing.
3) Line 104: Could the authors clarify that "mesh placement" refers to
postoperative mesh imaging?
Methods: 
1) Line 131: "Hence..." is an incomplete sentence and should be addended to the
previous sentence.
2) Line 132-133: Please keep "Clavien-Dindo" or "Dindo-Clavien" consistent
This is listed differently in the tables.
3) Lines 135-138: I understand the authors' wish to not repeat their cited paper
on technique. However, I recommend at least describing that all techniques used
the same suture type, mesh type, and sacral fixation techniques. 
4) Lines 164-166: Please list all the comparisons made -- I am assuming you
mean LSH to each hysterectomy-LSC type but also to each other? 
It should be
clear here.
Results:
1) In the presentation of results, please list your secondary analysis (between
subgroups) separately from your initial comparison. The primary objective
should be completely described first.
2) Both in the abstract and in the results, you list time as statistically significant
but it is actually >0.05 (the authors' point of significance). 
Please remove time as
a difference between groups (although the subgroup differences could be
described in a separate paragraph according to the point above). 
The EBLs in
each group are also not listed with their own p value -- in fact, these are NOT
significant. 
The subgroups are, but these should be reported after the primary
outcome.
Conclusions:
1) In the restatement of findings, as above, only list what is statistically
significant between main groups. 
Alternatively, you could state that EBL
difference was approaching significance (only true for time), but this is not
necessary as the 5 minutes are not clinically significant either. This is also true in
the final paragraph/Conclusion section.
2) Line 254: This sentence should be addended to the prior as it is incomplete.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
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from apparent manipulation?
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