Quality of life and its associated factors among women diagnosed with pelvic organ prolapse in Gynecology outpatient department Southern Nations, Nationalities, and Peoples region public referral hospitals, Ethiopia 2022

Quality of life and its associated factors among women diagnosed with pelvic organ prolapse in Gynecology outpatient department Southern Nations, Nationalities, and Peoples region public referral hospitals, Ethiopia 2022 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Quality of life and its associated factors among women diagnosed with pelvic organ prolapse in Gynecology outpatient department Southern Nations, Nationalities, and Peoples region public referral hospitals, Ethiopia 2022 Zewdu Tefera This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2409050/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Pelvic organ prolapse is an important public health issue influences millions of adult women’s lives; through limitations on physical, social, and sexual activities as well as psychological distress. However, there were no reports on the quality of life for women with pelvic organ prolapse in Ethiopia. Therefore this study amid to assess the magnitude of quality of life and its associated factors among women diagnosed with pelvic organ prolapse in Gynecology outpatient department Southern Nations, Nationalities, and Peoples region public referral hospitals; Ethiopia. Method An institutional-based cross-sectional study was conducted in Southern Nations, Nationalities, and Peoples region of public referral hospitals from May1-July 4, 2022 among 419 diagnosed women with pelvic organ prolapse. A validated tool was used to collect the data. The collected data were entered into EPI data version 3.1 and analyzed using the Statistical Package for Social Sciences. Bivariable and multivariable logistic regression was computed. The p-value of < 0.05 was used to declare the final statistical significance. Result A total of 409 women with pelvic organ prolapse were included in the study, giving a response rate of 97.6%. The overall poor quality of life was 57.5%. Regarding the quality of life domains; personal relationships (73.6%), were highly affected, and sleep/energy (24.2%) was the least affected domain. Stage III/IV prolapse (AOR = 4.61, 95% CI: 2.51, 8.48), menopause (AOR = 3.59, 95% CI: 1.85, 6.97), unmarried women(widowed, divorced) (AOR = 3.81, 95% CI: 2.02, 7.19), low-income level (AOR = 7.48, 95% CI: 3.67, 15.24), and longer duration of prolapse (AOR = 8.8, 95% CI: 4.81, 16.11), were significantly associated with poor quality of life. Conclusion More than half of women with pelvic organ prolapse had a poor quality of life. Stage III/IV prolapse, longer duration of prolapse, low-income level, menopause women, and unmarried women are statistically significant factors for the quality of life of women with POP. Therefore, Ethiopian Ministry of health with their stakeholders should develop an early detection and treatment strategy, and financial support for women with pelvic organ prolapse. Obstetrics & Gynecology pelvic organ prolapse quality of life associated factor Ethiopia Figures Figure 1 Figure 2 Background Pelvic organ prolapse (POP) is the descent of female pelvic organs into or through the vagina, including the bladder, uterus, and rectum (Charles R. B. Beckmann, 2010). This case results from the defect of the pelvic floor support, caused by many risk factors such as vaginal birth, advancing age, and increasing body mass index; atrophic changes caused by aging or estrogen loss, chronic straining, and abnormalities of connective tissue (Barber, 2016 ; Jelovsek, Maher, & Barber, 2007). The affected women may present with signs and symptoms of urinary or fecal loss or retention, vaginal pressure or heaviness, abdominal, low back, vaginal, or perennial pain or discomfort, a mass sensation, difficulty walking, lifting, sitting, and stress or fear related to anxiety about the problem (Barber, 2016 ; Charles R. B. Beckmann, 2010; Kumar, Padubidri, & Daftary, 2018 ). It is the leading indication for hysterectomy in postmenopausal women and accounts for 15–18% of procedures in all age groups (Kesharvarz H, 1994–1999. MMWR Surveill Summ 2002;). Compared to other gynecologic symptoms, pelvic organ prolapse were mostly affects HRQoL of women(Osama, 2015 ). The quality of life domains of women including physical, psychological, social interaction, sexual function, and hygiene are affected by pelvic organ prolapse (Davila, Ghoniem, & Wexner, 2006; Vitale SG, 2016). In low-income settings, discrimination against women with POP by family, and society are common, so this further worsens their QoL (Bonetti TR & 2004; Gjerde, Rortveit, Muleta, Adefris, & Blystad, 2017). Even though POP is a non-life-threatening condition, it is a major cause of morbidity in women and causes physical, social, psychological, occupational, domestic, and/or sexual limitations on their lifestyles (Samuelsson EC & 1999). In Southern Nation Nationality and Peoples Region of Ethiopia, there were high burdens of pelvic organ prolapse, and the most common cause was old age, long hours of carrying heavy objects, a high parity, a history of home delivery, a history of chronic constipation, and a history of chronic cough(Badacho, Lelu, & Gelan, 2020; Beketie et al., 2021 ) Pelvic organ prolapse is a significant public health issue that affects the lives of millions of adult women (Wilkins & Wu, 2016). On average, POP influenced 19.7% of women in developing countries (Walker & Gunasekera, 2011). Similarly in Ethiopia, it influenced 23.52% of women(Gedefaw & Demis, 2020 ). It has the potential to severely influence women’s health-related quality of life (HRQoL) through restrictions on physical, social, and sexual activities, psychological distress, and increased financial burden related to healthcare(Weber & Richter, 2005 ). In addition, access to health care to manage these conditions is often limited, and women usually have to live with the consequences for the rest of their lives(Wilkins & Wu, 2016). The quality of life of women with POP varying from country to country based on an economic level, lifestyle, educational level, and culture(Svihrova, Svihra, Luptak, Swift, & Digesu, 2014 ). However, a study showed that globally, the most common predominant risk factor for worsening QoL in women with POP is symptoms of POP (Davila et al., 2006 ; Fritel, Varnoux, Zins, Breart, & Ringa, 2009). Overall, pelvic floor disorders harm women’s lives, emotions, and quality of life, and they may be associated with a variety of systemic symptoms such as urinary, bowel, and sexual symptoms, which may significantly confront the quality of life of the women(Dietz & Maher, 2013 ; Hatthanirun P, 2015). Pelvic organ prolapse are more common, more severe, and highly affect women’s quality of life in developing countries compared to developed countries(Gjerde et al., 2017 ; Islam, Oldroyd, Rana, Romero, & Karim, 2019). However, in developing countries, the degree and consequences of the burden of the disease due to pelvic floor dysfunction, especially on the quality of life, are more poorly understood(Gunasekera P, 2007). In addition, the QoL of POP on women’s health has not yet been recognized as a public health problem in many developing countries. This is because only a few studies have examined POP about the normal deterioration of general health-related QOL in the general population (Vurgec & Beji, 2018 ; Walker & Gunasekera, 2011). In developed countries, the quality of life and its associated factor in women with POP is used as a baseline strategy for the treatment of POP, but in developing countries, especially in Africa, including Ethiopia not applicable, this is due to limited information on the quality of life of pelvic organ prolapse(Barber et al., 2007 ). Despite the quality of life allowing the quantification of morbidity, treatment efficacy and also acts as a measure of how lives are affected, and coping strategies, research has usually concentrated on the prevalence, etiology, diagnosis, and management of pelvic floor dysfunction, with limited work being performed on the effects of chronic conditions or their treatment on QoL(Sushma Srikrishna, June 2014). Pelvic organ prolapse is one of the sources of severe morbidity and psychological upheaval for the patient, who is often socially withdrawn and stigmatized and negatively influences the socioeconomic and reproductive activity of affected women (Haylen et al., 2010 ; Rogers, Villarreal, Kammerer-Doak, & Qualls, 2001 ). However, in Ethiopia, no reports were showing the quality of life of women with pelvic organ prolapse. Measuring the quality of life of women with POP is an important input for policymakers and program implementers to develop strategies. Methods Study area and period The study was conducted in South Nations, Nationalities, and Peoples Region (SNNPR). The SNNPR is bordered by Kenya to the south, South Sudan to the west, Gambela regional to the northwest, Oromia region to the north and east, South West region to the Southwest, and Sidama region to the east(Wikipedia, 2022 ). The region has 3-referral public hospitals 2 specialized and comprehensive hospitals, 3 general hospitals, 44 primary hospitals, 474 health centers, and 2633 health posts(bureau, 2022). The previous two-month report in the three referral public hospitals showed that there were four hundred seventy POP cases ("privious two months report in three public referral hospital in SNNPR," 2022). The data were collected from May 1, 2022-July 4, 2022 in public referral hospitals, SNNPR; Ethiopia 2022. Study population and eligibility criteria All women who were diagnosed with pelvic organ prolapse in Gynecology outpatient department SNNPR public referral hospitals during the data collection period. All women diagnosed with pelvic organ prolapse and had not get treatment before in the Gynecology outpatient department in all selected public referral hospitals were included. Sample size and sampling procedure The sample size was calculated using a single population formula (n= (Z α/2) 2 * P (1-P) ⁄ d 2 ) Based on a study conducted in Uganda, the proportion of poor QoL among POP women were 45.5%(Kayondo et al., 2021 ). Then, using the following assumptions: 95% of a confidence interval, α = 0.05 and margin of error = 5% the sample size required for this study was calculated. The calculated sample size was 381. By adding 10% of the non-response rate the final sample size was 419. All three public referral hospitals found in SNNPR were included in this study. The previous two months’ average POP report of each hospital was used to proportional allocate the calculated sample size. Finally, study respondents were selected using a consecutive sampling technique. Operational definitions Quality of Life (QoL) WHO defines quality of Life as an individual’s perception of their position in life in the context of the culture and value systems in which they live and about their goals, expectations, standards, and concern. It is a multi-dimensional concept that includes domains related to physical, mental, emotional, level of independence, and social functioning (WHO, 1998 May). Poor quality of life Greater or equal to the median score of the overall (nine) QoL domains(Brandt & van Vuuren, 2019; Digesu, Chaliha, Salvatore, Hutchings, & Khullar, 2005). Symptoms of prolapse a patient present with complaints of bladder, bowel, and pelvic symptoms (heaviness or dragging feeling from the vagina or the lower abdomen) (Digesu et al., 2005 ; Jelovsek et al., 2007 ). Duration of prolapse the number of months or years from the time pelvic organ prolapse first occurred until now(Belayneh et al., 2021 ). Stages of prolapse Based on Baden–Walker Halfway Scoring System: Stage 0: is no prolapse Stage I: is leading part of the prolapse is more than 1 cm above the hymen. Stage II: is leading edge is less than or equal to 1 cm above or below the hymen; Stage III: is leading edge is more than 1 cm beyond the hymen, but less than or equal to the total vaginal length; Stage IV: is complete eversion(Charles R. B. Beckmann, 2010; J.K. Oates; Jelovsek et al., 2007 ). Data collection tool and procedure The data collection tool was adopted from the University of Gondar validated tool on Prolapse quality of life questionnaire (P-QoL)(Belayneh, Gebeyehu, Adefris, Rortveit, & Genet, 2019). An interviewer-administered validated Amharic version questionnaire was used to collect the data. Women’s socio-demographic data, a factor associated with QoL were included in the tool. The questionnaire includes 20 items in nine different domains (General Health Condition and POP on the overall of life has one item, Role limitation, Social Limitation, Sleep/ Energy and physical limitation has two items, personal relationship and emotion has three items, intensity or Severity of Pain have four items). Questions are rated on a four-point Likert scale ranging from one to four, indicating better to worse conditions. This scale was converted into zero to hundred scales. Therefore, the total score is a range of 0-100. Each domain score was obtained by adding the scores of the individual items that comprise the domain. A full-scale score was obtained by the addition of nine-domain items. The lowest total score that can be on the scale is zero, and the highest score is 100. The cut-off point was the median of the total score(Cetinkaya, Dokmeci, & Dai, 2013). Three BSc midwives were recruited as data collectors and three MSc midwives as supervisors. The training was given to both data collectors and supervisors by the investigator about the objective of the study, data collection tool, procedure, and how to fill the questionnaires. All women who were newly diagnosed with POP in Gynecology outpatient department SNNPR public referral hospitals were interviewed after assessing eligibility and obtaining informed written consent and their charts were reviewed to assess the stage of the prolapse. Data quality assurance The training was given to data collectors and supervisors. A data collector was supervised throughout the data collection period. Then, the overall process was coordinated and controlled by the investigator. Investigators, supervisors, and data collectors took a discussion meeting after data collection to ensure completeness. Furthermore, the collected data was Checked and coded and entered into Epi-data computer program version 3.1 to minimize data entry errors. Data processing and analysis The collected data was entered into the EPI data version 3.1 computer program. Then, it was exported to Statistical Package for social science version 25. Descriptive statistics like frequency and summary statistics were employed to describe the characteristics of the study participants. Multicollinearity of the predictor variable was checked by using the variance inflation factor before binary logistic regression was done, and it was < 2 VIF for all independent variables. All explanatory variables in bivariable logistic regression that fulfill the chi square static assumption were considered for multivariable logistic regression analysis to control for confounding factors. Adjusted Odds Ratio (AOR) with their corresponding 95% Confidence Intervals (CI) and p-value less than 0.05 was used to declare the association between dependent and independent variables. Model fitness was checked by the Hosmer-Lemeshow test, it was fitted with a p-value of 0.554; finally presented by figure, table, and graph. Result Socio-demographic characteristics A total of 409 women were enrolled in the study, giving a 97.6% response rate. The age range of the participants is 36 to 72 years with a median of 54 years. Most of the respondents 220(53.8%) were married. Additionally, regarding educational status, 204 (49.87%) was non-educated (Table 1 ). Table 1 Socio-demographic characteristics among women diagnosed with POP in Gynecology outpatient department SNNPR public referral hospitals; Ethiopia 2022(n = 409). Variables Frequency (%) Age in years 35–49 50–59 ≥ 60 103(25.2) 187(45.7) 119(29.1) Residency Rural Urban 304(74.3) 105(25.7) Educational status Non-formal educated Primary Secondary and above 204(49.88) 161(39.36) 44(10.76) Marital status Married Divorced Widowed 220(53.8) 124(30.3) 65(15.9) Occupational status Farmer Housewife Government employ Merchant Private employ 219(53.54) 86(21.0) 46(11.24) 32(7.82) 26(6.4) Transport accessibility Constantly Never Rarely 157(38.38) 145(35.46) 107(26.16) Income level ≤ 2000 birr ≥ 4000 birr > 2000–4000 birr 269(65.78) 104(25.42) 36(8.8) Gynecologic and obstetrics characteristics For most respondents, 251(61.36%) prolapse were greater than two years durations. Regarding stages of prolapse, 153(37.4%) of women had stage III prolapse. Moreover, the parity ranged from4 to 14 with a mean and standard deviation of (8.23 ± 2.23), and 295(72.1%) of women had ≥ 7 number of childbirth (Table 2 ). Table 2 Gynecologic & obstetrics characteristics among women diagnosed with POP in Gynecology outpatient department SNNPR public referral hospitals, Ethiopia 2022(n = 409). Variables Frequency (%) Stages of prolapse Stage I Stage II Stage III Stage IV 76(18.6) 71(17.4) 153(37.4) 109(26.6) Duration of prolapse 1-2year > 2year 158(38.6) 251(61.4) Menopausal status Menopausal Premenopausal 290(70.9) 119(29.1) Parity 4–6 ≥ 7 114(27.9) 295(72.1) Decubitus ulcers Yes No 62(15.2) 347(84.8) The magnitude of quality of life of women with pelvic organ prolapse According to this study, the overall poor quality of life among women with POP was 235(57.5%) with (95% CI: 52.5, 62.3) (Fig. 3 ). Personal relationships 301(73.6%), the impact of pop 248(60.6%), and emotional well-being 239(58.4%) were domains of quality of life that had the highest score, whereas social limitation 142(34.7%) and sleep/energy 99(24.2%) had the lowest score (Table 3 ). Table 3 Quality of life domain score among women diagnosed with pelvic organ prolapse in Gynecology outpatient department SNNPR public referral hospitals, Ethiopia 2022(n = 409). Domains QoL domain score Median score Prevalence QoL domain score above median score (%) The overall quality of life General health condition Impact of prolapse Role limitation Physical limitation Social limitation Personal relationship Emotion Sleep/energy Severity measure 66.66 66.66 66.66 66.66 33.33 33.33 66.66 66.66 33.33 66.66 235(57.5) 216(52.8) 248(60.6) 233(57.0) 187(45.7) 142(34.7) 301(73.6) 239(58.4) 99(24.2) 238(58.2) Factor associated with QoL of women with pelvic organ prolapse To assess the relationship between various socio-demographic, obstetric, and POP-related factors and quality of life, binary logistic regression was used. The variables that full fill the chi square static assumption were maternal educational status, residency, marital status, parity, income level, transportation access, menopausal status, duration POP, and stage of POP. Then, using the backward likelihood ratio approach, these variables were subjected to multivariable logistic regression analysis. In the final model, only five variables were present. Model fitness was tested with the Hosmer and Lemeshow Goodness of fit test and fit with a p-value of 0.554. Additionally, all independent variables had no multicollinearity with a variance inflation factor value (VIF) < 2. This study shows that women with stage III/IV prolapse were 4.61 times more likely to have a poor quality of life than those with stage I or II prolapse (AOR = 4.61, 95% CI: 2.51, 8.48). In addition, women in the menopause period were 3.59 times more likely to have a poor quality of life than in the pre-menopause period (AOR = 3.59, 95% CI: 1.85, 6.97). Furthermore, the odds of having a poor quality of life were 3.81 times greater for women who were not married (widowed or divorced) than for those who were married (AOR = 3.81, 95% CI: 2.02, 7.19). Women with incomes of less than or equal to 2,000 Ethiopian Birr were 5.67 times more likely to have a poor quality of life than their counterparts (AOR = 7.48, 95% CI: 3.67, 15.24). Moreover, women with a longer duration of POP were 8.8 times more likely to have a poor quality of life than their counterparts (AOR = 8.8, 95% CI: 4.81, 16.11) (Table 4 ). Table 4 Factor associated with QoL among women diagnosed with POP in Gynecology outpatient department SNNPR public referral hospitals, Ethiopia 2022(n=409) Variables Quality of life Frequency (%) COR(95%CI) AOR(95%CI) P-value Poor Good Menopausal status Menopause Pre-menopause 197(48.16) 38(9.3) 93(22.74) 81(19.80) 4.51(2.85, 7.13) 1 3.59(1.85, 6.97) 1 < 0.001 * Stages of pop Stage III/IV Stage I/II 184(44.98) 51(12.46) 76(18.59) 98(23.97) 4.65(3.02, 7.16) 1 4.61(2.51, 8.48) 1 < 0.001 * Marital status unmarried Married 145(35.45) 90(22.00) 44(10.76) 130(31.79) 4.76(3.092, 7.32) 1 3.81(2.02, 7.19) 1 2 year ≤ 2year 200(48.9) 35(8.56) 51(12.47) 123(30.07) 13.78(8.48,22.39) 1 8.8(4.81, 16.11) 1 2000-4000 birr ≥ 4000 birr 198(48.41) 11(2.69) 26(6.36) 71(17.36) 25(6.11) 78(19.07) 8.36(4.97, 14.07) 1.32(0.57, 3.04) 1 7.48(3.67, 15.24) 1.54(0.51, 4.65 ) 1 < 0.001 * 0.439 Residency Rural Urban 203(49.63) 32(7.82) 101(24.70) 73(17.85) 4.58(2.83, 7.40) 1 1.87(0.908, 3.87) 1 0.089 Parity ≥ 7 4-6 195(47.68) 40(9.78) 100(24.45) 74(18.09) 3.6(2.29, 5.68) 1 1.41(0.614, 3.26) 1 Transport accessibility Never Rarely Constantly 110(26.9) 48(11.73) 77(18.83) 35(8.56) 59(14.42) 80(19.56) 3.26(1.99, 5.34) 0.84(0.51, 1.38) 1 1.62(0.73, 3.57) 0.55(0.24, 1.23) 1 0.247 Educational status Non-educated Primary Secondary and above 148(36.20) 68(16.62) 19(4.64) 56(13.70) 93(22.73) 25(6.11) 3.47(1.77, 6.80) 0.96(0.49, 1.88) 1 0.39(0.13, 1.16) 0.77(0.26, 2.28) 1 0.253 *Significant at P<0.001 Discussion This study showed that the overall poor quality of life among women who had pelvic organ prolapse was 57.5% (95%CI: 52.5, 62.3). This means that more than half of women with POP have a poor quality of life. This implicated that; although pelvic organ prolapse is a benign case, it highly influenced the quality of life of women. This finding is in line with a study conducted in France 54.5%(Christian Chauvin, 2012 ); Pakistan 60.8% (Jokhio, Rizvi, & MacArthur, 2020), and Slovakia 52.8% (Svihrova et al., 2014 ). This may be due to, although the quality of life of women with POP varies from country to country based on economic level, lifestyle, educational level, and culture, the most common predominant risk factors for worsening QoL of women are pelvic organ prolapse symptoms (Davila et al., 2006 ; Fritel et al., 2009). On another side, it is higher than a study conducted in Uganda 45.5% (Kayondo et al., 2021 ); Ghana 39.4%(Wusu-Ansah & Opare-Addo, 2008). This difference may be due to there being QoL domains and item differences, and there were sample size differences. In addition, this study showed that the quality of life of women with POP was significantly associated with the stages of the prolapse; stages III and IV were worse, the quality of life. This finding is supported by studies conducted in South Africa(Brandt & van Vuuren, 2019), Taiwan(Manchana & Bunyavejchevin, 2010 ), Thailand(Hatthanirun P, 2015), Nepal(Shrestha et al., 2015), USA(Jelovsek & Barber, 2006 ), Italy(Digesu et al., 2003 ), and London(Digesu et al., 2005 ). This may be because, as the prolapse progresses secondary consequences include decubitus ulcers, bowel symptoms, urinary symptoms, abdominal, and vaginal symptoms that worsen the quality of life of women(Digesu et al., 2005 ; Shrestha et al., 2015; Wusu-Ansah & Opare-Addo, 2008). Moreover, this study showed that there was a significant association between the quality of life of women with POP and longer durations of prolapse. This finding is supported by studies conducted in Pakistan(Jokhio et al., 2020 ), France(Fritel et al., 2009), and Bangladesh(Imoto, Sarker, Akter, Matsuyama, & Honda, 2021). This may be because, as the duration of the disease increased, there was progressive disability. In addition, as the duration of the prolapse increased, there were leads advanced stages of prolapse caused a symptomatic prolapse that worsens women’s health conditions(Fontenele et al., 2021 ). Consistently, this study showed that the low-income level of women with POP was strongly associated with a poor quality of life. This finding is supported by studies conducted in Bangladesh(Imoto et al., 2021) and South Africa(Brandt & van Vuuren, 2019). This may be because women who have low income with pelvic organ prolapse have incapacity of access to education, better control over a personal lifestyle, accessibility to housing, and environmental safety; this condition further worsens their quality of life. Furthermore, this study showed that women being unmarried (divorced, widowed) was strongly associated with poor quality of life of women. This finding is in line with studies conducted in Bangladesh(Imoto et al., 2021). This implicated, in fact being in a relationship, could be considered a buffer mechanism against psychological illnesses, reducing the likelihood of developing depressive symptoms, and isolation(Brandt & van Vuuren, 2019). In addition, loneliness women with pelvic organ prolapse had double responsibility to lead their life; this condition could be further worse for their lives. Moreover, this study showed that menopause women were strongly associated with poor quality of life. This finding is supported by studies conducted in Turkey(Vurgec & Beji, 2018 ). This could be due to as the women entered the menopausal stage there were physiological changes resulting in menopausal symptoms and worsening of the prolapse, which is a double burden to worse the quality of life of women(Charles R. B. Beckmann, 2010) Conclusion More than half of women with pelvic organ prolapse had a poor quality of life. Stage III/IV prolapse, longer duration of prolapse, low-income level, menopausal period, and unmarried women (widowed, divorced) are statistically significant factors for the quality of life of women with POP. Therefore Ethiopian Ministry of health with their stakeholders should focus on develop an early detection and treatment strategy, Offering the possibility of early diagnosis and treatment for women that has been hidden in the community, financially and psychological support to women with POP to prevent further impairment of their quality of life Abbreviations AOR--Adjusted Odds Ratio, OPD-- Outpatient Department, POP --Pelvic Organ Prolapse, QoL-- Quality of Life, SNNPR--Southern Nations, Nationalities, and Peoples Region Declarations Ethics approval and consent to participate : Ethical clearance was obtained from the Institutional Review board of College Health Science; Debre Markos university (study protocol number-159/2022). Then, officials at different levels in the hospitals were communicated through letters from College of Medicine and Health Science. Then, informed written consent from all participants were obtaind (while for women who cannot read and write legalized authorized representative was considered). Confidentiality of the information was secured throughout the study process. Finally, the results of study was used only for study purpose. Consent for publication : Not applicable Availability of data and materials : The datasets analyzed during the current study are available from the corresponding author upon reasonable request. Competing interest : the authors declare that they have no competing interest. Funding: There were no external organizations that funded this research. Authors’ contribution : ZT developed the project. ZT, BT, MA, TG, and AB participated in the methodology, data analysis and developing the initial drafts of the manuscript and revising subsequent drafts. ZT and MA prepared the final draft of the manuscript. All authors read and approved the final manuscript. Acknowledgment: We would like to thank Debre Markos University College of Medicine and Health Science to support this research project. The authors would also like to extend their gratitude southern region public referral hospitals, study participants, data collectors, and supervisors for their valuable contribution. References Badacho, Abebe Sorsa, Lelu, Mengistu Auro, & Gelan, Zegeye. (2020). Uterine prolapse and associated factors among reproductive age women in Dawro zone, southwest Ethiopia: a community based cross sectional study. Barber, Matthew D. (2016). Pelvic organ prolapse. Bmj, 354 . Barber, Matthew D, Amundsen, Cindy L, Paraiso, Marie FR, Weidner, Alison C, Romero, Audrey, & Walters, Mark D. (2007). Quality of life after surgery for genital prolapse in elderly women: obliterative and reconstructive surgery. International Urogynecology Journal, 18 (7), 799-806. Beketie, Eskedar Demissie, Tafese, Wubishet Tesfaye, Assefa, Zebene Mekonnen, Berriea, Fantahun Walle, Tilahun, Genet Asfaw, Shiferaw, Bisrat Zeleke, & Teke, Natnael Eshetu. (2021). Symptomatic pelvic floor disorders and its associated factors in South-Central Ethiopia. Plos one, 16 (7), e0254050. Belayneh, Tadesse, Gebeyehu, Abebaw, Adefris, Mulat, Rortveit, Guri, & Genet, Tinsae. (2019). Translation, transcultural adaptation, reliability and validation of the pelvic organ prolapse quality of life (P-QoL) in Amharic. Health and quality of life outcomes, 17 (1), 1-11. Belayneh, Tadesse, Gebeyehu, Abebaw, Adefris, Mulat, Rortveit, Guri, Gjerde, Janne Lillelid, & Ayele, Tadesse Awoke. (2021). Pelvic organ prolapse surgery and health-related quality of life: a follow-up study. BMC Women's Health, 21 (1), 1-11. Bonetti TR, Erpelding A, Pathak LR, & (2004). Listening to “felt needs” investigating genital prolapse in western Nepal. Reprod Health Matters, 12(23) , 166–175. 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BMC Urology, 12:9 . Davila, G Willy, Ghoniem, Gamal M, & Wexner, Steven D. (2006). Pelvic floor dysfunction : Springer. Dietz, Viviane, & Maher, Christopher. (2013). Pelvic organ prolapse and sexual function. International urogynecology journal, 24 (11), 1853-1857. Digesu, G Alessandro, Chaliha, Charlotte, Salvatore, Stefano, Hutchings, Anna, & Khullar, Vik. (2005). The relationship of vaginal prolapse severity tosymptoms and quality of life. BJOG: An International Journal of Obstetrics & Gynaecology, 112 (7), 971-976. Digesu, G Alessandro, Santamato, Sabino, Khullar, Vik, Santillo, Valeria, Digesu, Antonio, Cormio, Gennaro, . . . Selvaggi, Luigi. (2003). Validation of an Italian version of the prolapse quality of life questionnaire. European Journal of Obstetrics & Gynecology and Reproductive Biology, 106 (2), 184-192. Fontenele, Marta Quézia Silva, Moreira, Mayle Andrade, de Moura, Anna Caroline Ribeiro, de Figueiredo, Vilena Barros, Driusso, Patricia, & Nascimento, Simony Lira. (2021). Pelvic floor dysfunction distress is correlated with quality of life, but not with muscle function. Archives of Gynecology and Obstetrics, 303 (1), 143-149. Fritel, Xavier, Varnoux, Noëlle, Zins, Marie, Breart, Gérard, & Ringa, Virginie. (2009). Symptomatic pelvic organ prolapse at midlife, quality of life, and risk factors. Obstetrics and gynecology, 113 (3), 609. Gedefaw, Getnet, & Demis, Asmamaw. (2020). Burden of pelvic organ prolapse in Ethiopia: a systematic review and meta-analysis. BMC women's health, 20 (1), 1-9. Gjerde, Janne Lillelid, Rortveit, Guri, Muleta, Mulu, Adefris, Mulat, & Blystad, Astrid. (2017). Living with pelvic organ prolapse: voices of women from Amhara region, Ethiopia. International urogynecology journal, 28 (3), 361-366. Gunasekera P, Sazaki J, Walker G (2007). Pelvic organ prolapse: don't forget developing countries. Lancet 369 , 1789–1790. Hatthanirun P, Wattanayingcharoenchia R, Suthutvoravut S, Singhakajen V (2015). Quality of life in women with pelvic organ prolapse Haylen, Bernard T, De Ridder, Dirk, Freeman, Robert M, Swift, Steven E, Berghmans, Bary, Lee, Joseph, . . . Sand, Peter K. (2010). An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourology and Urodynamics: Official Journal of the International Continence Society, 29 (1), 4-20. Imoto, Atsuko, Sarker, Malabika, Akter, Rahima, Matsuyama, Akiko, & Honda, Sumihisa. (2021). Health-related quality of life in parous women with pelvic organ prolapse and/or urinary incontinence in Bangladesh. International Urogynecology Journal, 32 (4), 887-895. Islam, Rakibul M, Oldroyd, John, Rana, Juwel, Romero, Lorena, & Karim, Md Nazmul. (2019). Prevalence of symptomatic pelvic floor disorders in community-dwelling women in low and middle-income countries: a systematic review and meta-analysis. International urogynecology journal, 30 (12), 2001-2011. J.K. Oates, S. Abraham. Fundamentals of Obstetrics and Gynaecology, (8th edition ed.). Jelovsek, J Eric, & Barber, Matthew D. (2006). Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life. American journal of obstetrics and gynecology, 194 (5), 1455-1461. Jelovsek, J Eric, Maher, Christopher, & Barber, Matthew D. (2007). Pelvic organ prolapse. The Lancet, 369 (9566), 1027-1038. Jokhio, Abdul Hakeem, Rizvi, Raheela Mohsin, & MacArthur, Christine. (2020). Prevalence of pelvic organ prolapse in women, associated factors and impact on quality of life in rural Pakistan: population-based study. BMC women's health, 20 (1), 1-7. Kayondo, Musa, Kaye, Dan Kabonge, Migisha, Richard, Tugume, Rodgers, Kato, Paul Kalyebara, Lugobe, Henry Mark, & Geissbüehler, Verena. (2021). Impact of surgery on quality of life of Ugandan women with symptomatic pelvic organ prolapse: a prospective cohort study. BMC Women's Health, 21 (1), 1-7. Kesharvarz H, Hillis SD, Kieke BA, Marchbanks PA. . (1994–1999. MMWR Surveill Summ 2002;). Hysterectomy surveillance—United States 51 (SS05): , 1–8. Kumar, Sunesh, Padubidri, VG, & Daftary, Shirish N. (2018). Howkins & Bourne, Shaw's Textbook of Gynecology, -EBOOK : Elsevier Health Sciences. Manchana, Tarinee, & Bunyavejchevin, Suvit. (2010). Validation of the Prolapse Quality of Life (P-QOL) questionnaire in Thai version. International Urogynecology Journal, 21 (8), 985-993. Osama, Muhammad. (2015). Quality of life among women with symptoms of gynecological morbidities:. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology bs_bs_banner, 41, No. 4: 608–614, . privious two months report in three public referral hospital in SNNPR. (2022). unpublished reprort . Rogers, GR, Villarreal, A, Kammerer-Doak, D, & Qualls, C. (2001). Sexual function in women with and without urinary incontinence and/or pelvic organ prolapse. International urogynecology journal, 12 (6), 361-365. Samuelsson EC, Arne Victor FT, Tibblin G, Svardsudd KF, & (1999). Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Obstet Gynecol 180 , 299–305. Shrestha, Binjwala, Onta, Sharad, Choulagai, Bishnu, Paudel, Rajan, Petzold, Max, & Krettek, Alexandra. (2015). Uterine prolapse and its impact on quality of life in the Jhaukhel–Duwakot Health Demographic Surveillance Site, Bhaktapur, Nepal. Global health action, 8 (1), 28771. Sushma Srikrishna, Linda Cardozo. (June 2014). Quality of Life and Patient Reported Outcomes. The Global Library of Women’s Medicine’s . doi: 10.3843/GLOWM.10477 Svihrova, Viera, Svihra, Jan, Luptak, Jan, Swift, Steven, & Digesu, G Alessandro. (2014). Disability-adjusted life years (DALYs) in general population with pelvic organ prolapse: a study based on the prolapse quality-of-life questionnaire (P-QOL). European Journal of Obstetrics & Gynecology and Reproductive Biology, 182 , 22-26. Vitale SG, Lagana AS, Gulino FA, Tropea A, Tarda S. (2016). Prosthetic surgery versus native tissue repair of cystocele. Updates Surg., 68(4) , 325–329. Vurgec, Burcu Avcibay, & Beji, Nezihe Kizilkaya. (2018). Quality of life and sexual life in women with advanced stage pelvic organ prolapse. Cukurova Medical Journal, 43 (Ek 1), 230-239. Walker, Godfrey JA, & Gunasekera, Prasanna. (2011). Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors. International urogynecology journal, 22 (2), 127-135. Weber, Anne M, & Richter, Holly E. (2005). Pelvic organ prolapse. Obstetrics & Gynecology, 106 (3), 615-634. WHO. (1998 May). quality of life assessment. Psychological medicine. , 28(3) , 551-558. Wikipedia, the free encyclopedia. (2022). Southern nations, Ntionalities and peoples Region https://en.wikipedia.org/wiki/Southern_Nations,_Nationalities,_and_Peoples%27_Region . Wilkins, Maggie F, & Wu, Jennifer M. (2016). Epidemiology of pelvic organ prolapse. Current Obstetrics and Gynecology Reports, 5 (2), 119-123. Wusu-Ansah, Osei K, & Opare-Addo, Henry S. (2008). Pelvic organ prolapse in rural Ghana. International Journal of Gynecology & Obstetrics, 103 (2), 121-124. Supplementary Files APPENDIXES.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2409050","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":162498145,"identity":"1e4296bd-4b34-4196-aee7-c9f99a31f6c0","order_by":0,"name":"Zewdu Tefera","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA2UlEQVRIiWNgGAWjYJACCQYGGzl+9gYg08CCWC0JacaSPQdAWiSI1nI4ccONBKiNhIB8e4/hbd4fzIwNN59f3fCjQIKBv707Aa8Wxp4zxtY8CWzMjLNzym72AB0mcebsBrxamCVyt0nzJPCwMUvnpN3gAWoxkMjFr4VN/i1IiwQPm+SZtJt/iNHCI8EL0mIgwSPBfuw2UbZI8OR/tpyTBtKTw3ZbBqSVkF/k248l3nhj879+//Hjz26++QOM0/Ze/FqQ3WgAJolVDgLsD0hRPQpGwSgYBSMIAACPREGnHpRfzgAAAABJRU5ErkJggg==","orcid":"","institution":"Dilla university","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Zewdu","middleName":"","lastName":"Tefera","suffix":""}],"badges":[],"createdAt":"2022-12-23 13:52:48","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":true,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false,"coiExplicitlySet":false},"doi":"10.21203/rs.3.rs-2409050/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2409050/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":31122306,"identity":"9a5fc50e-2748-46ef-8ff7-63d0e1f45593","added_by":"auto","created_at":"2023-01-04 21:10:24","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":280132,"visible":true,"origin":"","legend":"\u003cp\u003e2: Schematic presentation of sampling procedure to assess the quality of life and its associated factor among 419 women diagnosed with pelvic organ prolapse, in Gynecology outpatient department SNNPR public referral hospitals; Ethiopia 2022\u003c/p\u003e","description":"","filename":"Fig1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2409050/v1/03e2974ca8bf76984d9c6084.jpg"},{"id":31122135,"identity":"553acbb7-9a32-4b1f-9114-63191c5116e5","added_by":"auto","created_at":"2023-01-04 21:02:24","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":118037,"visible":true,"origin":"","legend":"\u003cp\u003e3:\u003cstrong\u003e \u003c/strong\u003eMagnitude of quality of life among women diagnosed with pelvic organ prolapse in Gynecology outpatient department SNNPR public referral hospitals, Ethiopia 2022(n=409).\u003c/p\u003e","description":"","filename":"Fig2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2409050/v1/a0b978333c1f984add37a513.jpg"},{"id":31122307,"identity":"04162411-5cb8-46fe-9e68-6f41f22529d7","added_by":"auto","created_at":"2023-01-04 21:10:30","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":493854,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2409050/v1/bd0f027f-18c9-4541-9fc1-7082f814ad7c.pdf"},{"id":31122137,"identity":"95793fca-9539-4080-a14b-5c82cc58cfd8","added_by":"auto","created_at":"2023-01-04 21:02:24","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":70039,"visible":true,"origin":"","legend":"","description":"","filename":"APPENDIXES.docx","url":"https://assets-eu.researchsquare.com/files/rs-2409050/v1/2ec0429df2c44a73d1ec4768.docx"}],"financialInterests":"","formattedTitle":"\u003cp\u003e\u003cstrong\u003eQuality of life and its associated factors among women diagnosed with pelvic organ prolapse in Gynecology outpatient department Southern Nations, Nationalities, and Peoples region public referral hospitals, Ethiopia 2022\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003ePelvic organ prolapse (POP) is the descent of female pelvic organs into or through the vagina, including the bladder, uterus, and rectum (Charles R. B. Beckmann, 2010). This case results from the defect of the pelvic floor support, caused by many risk factors such as vaginal birth, advancing age, and increasing body mass index; atrophic changes caused by aging or estrogen loss, chronic straining, and abnormalities of connective tissue (Barber, \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e; Jelovsek, Maher, \u0026amp; Barber, 2007).\u003c/p\u003e\n\u003cp\u003eThe affected women may present with signs and symptoms of urinary or fecal loss or retention, vaginal pressure or heaviness, abdominal, low back, vaginal, or perennial pain or discomfort, a mass sensation, difficulty walking, lifting, sitting, and stress or fear related to anxiety about the problem (Barber, \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e; Charles R. B. Beckmann, 2010; Kumar, Padubidri, \u0026amp; Daftary, \u003cspan class=\"CitationRef\"\u003e2018\u003c/span\u003e). It is the leading indication for hysterectomy in postmenopausal women and accounts for 15\u0026ndash;18% of procedures in all age groups (Kesharvarz H, 1994\u0026ndash;1999. MMWR Surveill Summ 2002;).\u003c/p\u003e\n\u003cp\u003eCompared to other gynecologic symptoms, pelvic organ prolapse were mostly affects HRQoL of women(Osama, \u003cspan class=\"CitationRef\"\u003e2015\u003c/span\u003e). The quality of life domains of women including physical, psychological, social interaction, sexual function, and hygiene are affected by pelvic organ prolapse (Davila, Ghoniem, \u0026amp; Wexner, 2006; Vitale SG, 2016). In low-income settings, discrimination against women with POP by family, and society are common, so this further worsens their QoL (Bonetti TR \u0026amp; 2004; Gjerde, Rortveit, Muleta, Adefris, \u0026amp; Blystad, 2017). Even though POP is a non-life-threatening condition, it is a major cause of morbidity in women and causes physical, social, psychological, occupational, domestic, and/or sexual limitations on their lifestyles (Samuelsson EC \u0026amp; 1999).\u003c/p\u003e\n\u003cp\u003eIn Southern Nation Nationality and Peoples Region of Ethiopia, there were high burdens of pelvic organ prolapse, and the most common cause was old age, long hours of carrying heavy objects, a high parity, a history of home delivery, a history of chronic constipation, and a history of chronic cough(Badacho, Lelu, \u0026amp; Gelan, 2020; Beketie et al., \u003cspan class=\"CitationRef\"\u003e2021\u003c/span\u003e)\u003c/p\u003e\n\u003cp\u003ePelvic organ prolapse is a significant public health issue that affects the lives of millions of adult women (Wilkins \u0026amp; Wu, 2016). On average, POP influenced 19.7% of women in developing countries (Walker \u0026amp; Gunasekera, 2011). Similarly in Ethiopia, it influenced 23.52% of women(Gedefaw \u0026amp; Demis, \u003cspan class=\"CitationRef\"\u003e2020\u003c/span\u003e). It has the potential to severely influence women\u0026rsquo;s health-related quality of life (HRQoL) through restrictions on physical, social, and sexual activities, psychological distress, and increased financial burden related to healthcare(Weber \u0026amp; Richter, \u003cspan class=\"CitationRef\"\u003e2005\u003c/span\u003e). In addition, access to health care to manage these conditions is often limited, and women usually have to live with the consequences for the rest of their lives(Wilkins \u0026amp; Wu, 2016).\u003c/p\u003e\n\u003cp\u003eThe quality of life of women with POP varying from country to country based on an economic level, lifestyle, educational level, and culture(Svihrova, Svihra, Luptak, Swift, \u0026amp; Digesu, \u003cspan class=\"CitationRef\"\u003e2014\u003c/span\u003e). However, a study showed that globally, the most common predominant risk factor for worsening QoL in women with POP is symptoms of POP (Davila et al., \u003cspan class=\"CitationRef\"\u003e2006\u003c/span\u003e; Fritel, Varnoux, Zins, Breart, \u0026amp; Ringa, 2009). Overall, pelvic floor disorders harm women\u0026rsquo;s lives, emotions, and quality of life, and they may be associated with a variety of systemic symptoms such as urinary, bowel, and sexual symptoms, which may significantly confront the quality of life of the women(Dietz \u0026amp; Maher, \u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e; Hatthanirun P, 2015).\u003c/p\u003e\n\u003cp\u003ePelvic organ prolapse are more common, more severe, and highly affect women\u0026rsquo;s quality of life in developing countries compared to developed countries(Gjerde et al., \u003cspan class=\"CitationRef\"\u003e2017\u003c/span\u003e; Islam, Oldroyd, Rana, Romero, \u0026amp; Karim, 2019). However, in developing countries, the degree and consequences of the burden of the disease due to pelvic floor dysfunction, especially on the quality of life, are more poorly understood(Gunasekera P, 2007). In addition, the QoL of POP on women\u0026rsquo;s health has not yet been recognized as a public health problem in many developing countries. This is because only a few studies have examined POP about the normal deterioration of general health-related QOL in the general population (Vurgec \u0026amp; Beji, \u003cspan class=\"CitationRef\"\u003e2018\u003c/span\u003e; Walker \u0026amp; Gunasekera, 2011).\u003c/p\u003e\n\u003cp\u003eIn developed countries, the quality of life and its associated factor in women with POP is used as a baseline strategy for the treatment of POP, but in developing countries, especially in Africa, including Ethiopia not applicable, this is due to limited information on the quality of life of pelvic organ prolapse(Barber et al., \u003cspan class=\"CitationRef\"\u003e2007\u003c/span\u003e). Despite the quality of life allowing the quantification of morbidity, treatment efficacy and also acts as a measure of how lives are affected, and coping strategies, research has usually concentrated on the prevalence, etiology, diagnosis, and management of pelvic floor dysfunction, with limited work being performed on the effects of chronic conditions or their treatment on QoL(Sushma Srikrishna, June 2014).\u003c/p\u003e\n\u003cp\u003ePelvic organ prolapse is one of the sources of severe morbidity and psychological upheaval for the patient, who is often socially withdrawn and stigmatized and negatively influences the socioeconomic and reproductive activity of affected women (Haylen et al., \u003cspan class=\"CitationRef\"\u003e2010\u003c/span\u003e; Rogers, Villarreal, Kammerer-Doak, \u0026amp; Qualls, \u003cspan class=\"CitationRef\"\u003e2001\u003c/span\u003e). However, in Ethiopia, no reports were showing the quality of life of women with pelvic organ prolapse. Measuring the quality of life of women with POP is an important input for policymakers and program implementers to develop strategies.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eStudy area and period\u003c/p\u003e\n\u003cp\u003eThe study was conducted in South Nations, Nationalities, and Peoples Region (SNNPR). The SNNPR is bordered by Kenya to the south, South Sudan to the west, Gambela regional to the northwest, Oromia region to the north and east, South West region to the Southwest, and Sidama region to the east(Wikipedia, \u003cspan class=\"CitationRef\"\u003e2022\u003c/span\u003e). The region has 3-referral public hospitals 2 specialized and comprehensive hospitals, 3 general hospitals, 44 primary hospitals, 474 health centers, and 2633 health posts(bureau, 2022). The previous two-month report in the three referral public hospitals showed that there were four hundred seventy POP cases (\u0026quot;privious two months report in three public referral hospital in SNNPR,\u0026quot; 2022). The data were collected from May 1, 2022-July 4, 2022 in public referral hospitals, SNNPR; Ethiopia 2022.\u003c/p\u003e\n\u003cdiv class=\"Section2\" id=\"Sec2\"\u003e\n \u003cp\u003eStudy population and eligibility criteria\u003c/p\u003e\n \u003cp\u003eAll women who were diagnosed with pelvic organ prolapse in Gynecology outpatient department SNNPR public referral hospitals during the data collection period. All women diagnosed with pelvic organ prolapse and had not get treatment before in the Gynecology outpatient department in all selected public referral hospitals were included.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Section2\" id=\"Sec3\"\u003e\n \u003cp\u003eSample size and sampling procedure\u003c/p\u003e\n \u003cp\u003eThe sample size was calculated using a single population formula (n= (Z \u0026alpha;/2)\u003csup\u003e2\u003c/sup\u003e\u003csub\u003e*\u003c/sub\u003e P (1-P) \u0026frasl; d\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003cp\u003eBased on a study conducted in Uganda, the proportion of poor QoL among POP women were 45.5%(Kayondo et al., \u003cspan class=\"CitationRef\"\u003e2021\u003c/span\u003e). Then, using the following assumptions: 95% of a confidence interval, \u0026alpha;\u0026thinsp;=\u0026thinsp;0.05 and margin of error\u0026thinsp;=\u0026thinsp;5% the sample size required for this study was calculated.\u003c/p\u003e\n \u003cp\u003eThe calculated sample size was 381. By adding 10% of the non-response rate the final sample size was 419.\u003c/p\u003e\n \u003cp\u003eAll three public referral hospitals found in SNNPR were included in this study. The previous two months\u0026rsquo; average POP report of each hospital was used to proportional allocate the calculated sample size. Finally, study respondents were selected using a consecutive sampling technique.\u003c/p\u003e\n \u003cp\u003eOperational definitions\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eQuality of Life (QoL)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eWHO defines quality of Life as an individual\u0026rsquo;s perception of their position in life in the context of the culture and value systems in which they live and about their goals, expectations, standards, and concern. It is a multi-dimensional concept that includes domains related to physical, mental, emotional, level of independence, and social functioning (WHO, \u003cspan class=\"CitationRef\"\u003e1998\u003c/span\u003e May).\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ePoor quality of life\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eGreater or equal to the median score of the overall (nine) QoL domains(Brandt \u0026amp; van Vuuren, 2019; Digesu, Chaliha, Salvatore, Hutchings, \u0026amp; Khullar, 2005).\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSymptoms of prolapse\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003ea patient present with complaints of bladder, bowel, and pelvic symptoms (heaviness or dragging feeling from the vagina or the lower abdomen) (Digesu et al., \u003cspan class=\"CitationRef\"\u003e2005\u003c/span\u003e; Jelovsek et al., \u003cspan class=\"CitationRef\"\u003e2007\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of prolapse\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003ethe number of months or years from the time pelvic organ prolapse first occurred until now(Belayneh et al., \u003cspan class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\n \u003cdiv class=\"Section3\" id=\"Sec4\"\u003e\n \u003cp\u003e\u003cstrong\u003eStages of prolapse\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eBased on Baden\u0026ndash;Walker Halfway Scoring System:\u003c/p\u003e\n \u003cp\u003eStage 0: is no prolapse\u003c/p\u003e\n \u003cp\u003eStage I: is leading part of the prolapse is more than 1 cm above the hymen.\u003c/p\u003e\n \u003cp\u003eStage II: is leading edge is less than or equal to 1 cm above or below the hymen;\u003c/p\u003e\n \u003cp\u003eStage III: is leading edge is more than 1 cm beyond the hymen, but less than or equal to the total vaginal length;\u003c/p\u003e\n \u003cp\u003eStage IV: is complete eversion(Charles R. B. Beckmann, 2010; J.K. Oates; Jelovsek et al., \u003cspan class=\"CitationRef\"\u003e2007\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003eData collection tool and procedure\u003c/p\u003e\n \u003cp\u003eThe data collection tool was adopted from the University of Gondar validated tool on Prolapse quality of life questionnaire (P-QoL)(Belayneh, Gebeyehu, Adefris, Rortveit, \u0026amp; Genet, 2019). An interviewer-administered validated Amharic version questionnaire was used to collect the data. Women\u0026rsquo;s socio-demographic data, a factor associated with QoL were included in the tool. The questionnaire includes 20 items in nine different domains (General Health Condition and POP on the overall of life has one item, Role limitation, Social Limitation, Sleep/ Energy and physical limitation has two items, personal relationship and emotion has three items, intensity or Severity of Pain have four items).\u003c/p\u003e\n \u003cp\u003eQuestions are rated on a four-point Likert scale ranging from one to four, indicating better to worse conditions. This scale was converted into zero to hundred scales. Therefore, the total score is a range of 0-100. Each domain score was obtained by adding the scores of the individual items that comprise the domain. A full-scale score was obtained by the addition of nine-domain items. The lowest total score that can be on the scale is zero, and the highest score is 100. The cut-off point was the median of the total score(Cetinkaya, Dokmeci, \u0026amp; Dai, 2013).\u003c/p\u003e\n \u003cp\u003eThree BSc midwives were recruited as data collectors and three MSc midwives as supervisors. The training was given to both data collectors and supervisors by the investigator about the objective of the study, data collection tool, procedure, and how to fill the questionnaires. All women who were newly diagnosed with POP in Gynecology outpatient department SNNPR public referral hospitals were interviewed after assessing eligibility and obtaining informed written consent and their charts were reviewed to assess the stage of the prolapse.\u003c/p\u003e\n \u003cp\u003eData quality assurance\u003c/p\u003e\n \u003cp\u003eThe training was given to data collectors and supervisors. A data collector was supervised throughout the data collection period. Then, the overall process was coordinated and controlled by the investigator. Investigators, supervisors, and data collectors took a discussion meeting after data collection to ensure completeness. Furthermore, the collected data was Checked and coded and entered into Epi-data computer program version 3.1 to minimize data entry errors.\u003c/p\u003e\n \u003cp\u003eData processing and analysis\u003c/p\u003e\n \u003cp\u003eThe collected data was entered into the EPI data version 3.1 computer program. Then, it was exported to Statistical Package for social science version 25. Descriptive statistics like frequency and summary statistics were employed to describe the characteristics of the study participants. Multicollinearity of the predictor variable was checked by using the variance inflation factor before binary logistic regression was done, and it was \u0026lt;\u0026thinsp;2 VIF for all independent variables. All explanatory variables in bivariable logistic regression that fulfill the chi square static assumption were considered for multivariable logistic regression analysis to control for confounding factors. Adjusted Odds Ratio (AOR) with their corresponding 95% Confidence Intervals (CI) and p-value less than 0.05 was used to declare the association between dependent and independent variables. Model fitness was checked by the Hosmer-Lemeshow test, it was fitted with a p-value of 0.554; finally presented by figure, table, and graph.\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e"},{"header":"Result","content":"\u003cp\u003eSocio-demographic characteristics\u003c/p\u003e\n\u003cp\u003eA total of 409 women were enrolled in the study, giving a 97.6% response rate. The age range of the participants is 36 to 72 years with a median of 54 years. Most of the respondents 220(53.8%) were married. Additionally, regarding educational status, 204 (49.87%) was non-educated (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eSocio-demographic characteristics among women diagnosed with POP in Gynecology outpatient department SNNPR public referral hospitals; Ethiopia 2022(n\u0026thinsp;=\u0026thinsp;409).\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eVariables\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eFrequency (%)\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eAge in years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e35\u0026ndash;49\u003c/p\u003e\n\u003cp\u003e50\u0026ndash;59\u003c/p\u003e\n\u003cp\u003e\u0026ge;\u0026thinsp;60\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e103(25.2)\u003c/p\u003e\n\u003cp\u003e187(45.7)\u003c/p\u003e\n\u003cp\u003e119(29.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eResidency\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eRural\u003c/p\u003e\n\u003cp\u003eUrban\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e304(74.3)\u003c/p\u003e\n\u003cp\u003e105(25.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eEducational status\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNon-formal educated\u003c/p\u003e\n\u003cp\u003ePrimary\u003c/p\u003e\n\u003cp\u003eSecondary and above\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e204(49.88)\u003c/p\u003e\n\u003cp\u003e161(39.36)\u003c/p\u003e\n\u003cp\u003e44(10.76)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eMarital status\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMarried\u003c/p\u003e\n\u003cp\u003eDivorced\u003c/p\u003e\n\u003cp\u003eWidowed\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e220(53.8)\u003c/p\u003e\n\u003cp\u003e124(30.3)\u003c/p\u003e\n\u003cp\u003e65(15.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eOccupational status\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFarmer\u003c/p\u003e\n\u003cp\u003eHousewife\u003c/p\u003e\n\u003cp\u003eGovernment employ\u003c/p\u003e\n\u003cp\u003eMerchant\u003c/p\u003e\n\u003cp\u003ePrivate employ\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e219(53.54)\u003c/p\u003e\n\u003cp\u003e86(21.0)\u003c/p\u003e\n\u003cp\u003e46(11.24)\u003c/p\u003e\n\u003cp\u003e32(7.82)\u003c/p\u003e\n\u003cp\u003e26(6.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eTransport accessibility\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eConstantly\u003c/p\u003e\n\u003cp\u003eNever\u003c/p\u003e\n\u003cp\u003eRarely\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e157(38.38)\u003c/p\u003e\n\u003cp\u003e145(35.46)\u003c/p\u003e\n\u003cp\u003e107(26.16)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eIncome level\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026le;\u0026thinsp;2000 birr\u003c/p\u003e\n\u003cp\u003e\u0026ge;\u0026thinsp;4000 birr\u003c/p\u003e\n\u003cp\u003e\u0026gt;\u0026thinsp;2000\u0026ndash;4000 birr\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e269(65.78)\u003c/p\u003e\n\u003cp\u003e104(25.42)\u003c/p\u003e\n\u003cp\u003e36(8.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGynecologic and obstetrics characteristics\u003c/p\u003e\n\u003c/div\u003e\n\u003cp\u003eFor most respondents, 251(61.36%) prolapse were greater than two years durations. Regarding stages of prolapse, 153(37.4%) of women had stage III prolapse. Moreover, the parity ranged from4 to 14 with a mean and standard deviation of (8.23\u0026thinsp;\u0026plusmn;\u0026thinsp;2.23), and 295(72.1%) of women had\u0026thinsp;\u0026ge;\u0026thinsp;7 number of childbirth (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eGynecologic \u0026amp; obstetrics characteristics among women diagnosed with POP in Gynecology outpatient department SNNPR public referral hospitals, Ethiopia 2022(n\u0026thinsp;=\u0026thinsp;409).\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eVariables\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eFrequency (%)\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eStages of prolapse\u003c/strong\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eStage I\u003c/p\u003e\n\u003cp\u003eStage II\u003c/p\u003e\n\u003cp\u003eStage III\u003c/p\u003e\n\u003cp\u003eStage IV\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e76(18.6)\u003c/p\u003e\n\u003cp\u003e71(17.4)\u003c/p\u003e\n\u003cp\u003e153(37.4)\u003c/p\u003e\n\u003cp\u003e109(26.6)\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eDuration of prolapse\u003c/strong\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e1-2year\u003c/p\u003e\n\u003cp\u003e\u0026gt;\u0026thinsp;2year\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e158(38.6)\u003c/p\u003e\n\u003cp\u003e251(61.4)\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eMenopausal status\u003c/strong\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eMenopausal\u003c/p\u003e\n\u003cp\u003ePremenopausal\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e290(70.9)\u003c/p\u003e\n\u003cp\u003e119(29.1)\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eParity\u003c/strong\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e4\u0026ndash;6\u003c/p\u003e\n\u003cp\u003e\u0026ge;\u0026thinsp;7\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e114(27.9)\u003c/p\u003e\n\u003cp\u003e295(72.1)\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eDecubitus ulcers\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e62(15.2)\u003c/p\u003e\n\u003cp\u003e347(84.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003cp\u003eThe magnitude of quality of life of women with pelvic organ prolapse\u003c/p\u003e\n\u003cp\u003eAccording to this study, the overall poor quality of life among women with POP was 235(57.5%) with (95% CI: 52.5, 62.3) (Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e). Personal relationships 301(73.6%), the impact of pop 248(60.6%), and emotional well-being 239(58.4%) were domains of quality of life that had the highest score, whereas social limitation 142(34.7%) and sleep/energy 99(24.2%) had the lowest score (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eQuality of life domain score among women diagnosed with pelvic organ prolapse in Gynecology outpatient department SNNPR public referral hospitals, Ethiopia 2022(n\u0026thinsp;=\u0026thinsp;409).\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eDomains\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eQoL domain score\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eMedian score\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003ePrevalence QoL domain score above median score (%)\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe overall quality of life\u003c/p\u003e\n\u003cp\u003eGeneral health condition\u003c/p\u003e\n\u003cp\u003eImpact of prolapse\u003c/p\u003e\n\u003cp\u003eRole limitation\u003c/p\u003e\n\u003cp\u003ePhysical limitation\u003c/p\u003e\n\u003cp\u003eSocial limitation\u003c/p\u003e\n\u003cp\u003ePersonal relationship\u003c/p\u003e\n\u003cp\u003eEmotion\u003c/p\u003e\n\u003cp\u003eSleep/energy\u003c/p\u003e\n\u003cp\u003eSeverity measure\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e66.66\u003c/p\u003e\n\u003cp\u003e66.66\u003c/p\u003e\n\u003cp\u003e66.66\u003c/p\u003e\n\u003cp\u003e66.66\u003c/p\u003e\n\u003cp\u003e33.33\u003c/p\u003e\n\u003cp\u003e33.33\u003c/p\u003e\n\u003cp\u003e66.66\u003c/p\u003e\n\u003cp\u003e66.66\u003c/p\u003e\n\u003cp\u003e33.33\u003c/p\u003e\n\u003cp\u003e66.66\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e235(57.5)\u003c/p\u003e\n\u003cp\u003e216(52.8)\u003c/p\u003e\n\u003cp\u003e248(60.6)\u003c/p\u003e\n\u003cp\u003e233(57.0)\u003c/p\u003e\n\u003cp\u003e187(45.7)\u003c/p\u003e\n\u003cp\u003e142(34.7)\u003c/p\u003e\n\u003cp\u003e301(73.6)\u003c/p\u003e\n\u003cp\u003e239(58.4)\u003c/p\u003e\n\u003cp\u003e99(24.2)\u003c/p\u003e\n\u003cp\u003e238(58.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003cp\u003eFactor associated with QoL of women with pelvic organ prolapse\u003c/p\u003e\n\u003cp\u003eTo assess the relationship between various socio-demographic, obstetric, and POP-related factors and quality of life, binary logistic regression was used. The variables that full fill the chi square static assumption were maternal educational status, residency, marital status, parity, income level, transportation access, menopausal status, duration POP, and stage of POP. Then, using the backward likelihood ratio approach, these variables were subjected to multivariable logistic regression analysis. In the final model, only five variables were present. Model fitness was tested with the Hosmer and Lemeshow Goodness of fit test and fit with a p-value of 0.554. Additionally, all independent variables had no multicollinearity with a variance inflation factor value (VIF)\u0026thinsp;\u0026lt;\u0026thinsp;2.\u003c/p\u003e\n\u003cp\u003eThis study shows that women with stage III/IV prolapse were 4.61 times more likely to have a poor quality of life than those with stage I or II prolapse (AOR\u0026thinsp;=\u0026thinsp;4.61, 95% CI: 2.51, 8.48). In addition, women in the menopause period were 3.59 times more likely to have a poor quality of life than in the pre-menopause period (AOR\u0026thinsp;=\u0026thinsp;3.59, 95% CI: 1.85, 6.97). Furthermore, the odds of having a poor quality of life were 3.81 times greater for women who were not married (widowed or divorced) than for those who were married (AOR\u0026thinsp;=\u0026thinsp;3.81, 95% CI: 2.02, 7.19). Women with incomes of less than or equal to 2,000 Ethiopian Birr were 5.67 times more likely to have a poor quality of life than their counterparts (AOR\u0026thinsp;=\u0026thinsp;7.48, 95% CI: 3.67, 15.24). Moreover, women with a longer duration of POP were 8.8 times more likely to have a poor quality of life than their counterparts (AOR\u0026thinsp;=\u0026thinsp;8.8, 95% CI: 4.81, 16.11) (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\n\u003ctable border=\"1\"\u003e\u003ccaption\u003e\n\u003cp\u003eTable 4\u003c/p\u003e\n\u003cp\u003eFactor associated with QoL among women diagnosed with POP in Gynecology outpatient department SNNPR public referral hospitals, Ethiopia 2022(n=409)\u003c/p\u003e\n\u003c/caption\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 105px;\" colspan=\"2\" rowspan=\"3\" width=\"216\"\u003e\n\u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" colspan=\"5\" width=\"510\"\u003e\n\u003cp\u003e\u003cstrong\u003eQuality of life \u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" colspan=\"2\" width=\"180\"\u003e\n\u003cp\u003eFrequency (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 70px;\" rowspan=\"2\" width=\"132\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCOR(95%CI)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 70px;\" rowspan=\"2\" width=\"126\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAOR(95%CI)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 70px;\" rowspan=\"2\" width=\"72\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" width=\"90\"\u003e\n\u003cp\u003ePoor\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" width=\"90\"\u003e\n\u003cp\u003eGood\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 59px;\"\u003e\n\u003ctd style=\"height: 59px;\" width=\"96\"\u003e\n\u003cp\u003eMenopausal status\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"120\"\u003e\n\u003cp\u003eMenopause\u003c/p\u003e\n\u003cp\u003ePre-menopause\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"90\"\u003e\n\u003cp\u003e197(48.16)\u003c/p\u003e\n\u003cp\u003e38(9.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"90\"\u003e\n\u003cp\u003e93(22.74)\u003c/p\u003e\n\u003cp\u003e81(19.80)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"132\"\u003e\n\u003cp\u003e4.51(2.85, 7.13)\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"126\"\u003e\n\u003cp\u003e3.59(1.85, 6.97)\u003c/p\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"72\"\u003e\n\u003cp\u003e\u0026lt;\u003cstrong\u003e0.001\u003c/strong\u003e\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 59px;\"\u003e\n\u003ctd style=\"height: 59px;\" width=\"96\"\u003e\n\u003cp\u003eStages of pop\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"120\"\u003e\n\u003cp\u003eStage III/IV\u003c/p\u003e\n\u003cp\u003eStage I/II\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"90\"\u003e\n\u003cp\u003e184(44.98)\u003c/p\u003e\n\u003cp\u003e51(12.46)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"90\"\u003e\n\u003cp\u003e76(18.59)\u003c/p\u003e\n\u003cp\u003e98(23.97)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"132\"\u003e\n\u003cp\u003e\u0026nbsp;4.65(3.02, 7.16)\u003c/p\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"126\"\u003e\n\u003cp\u003e4.61(2.51, 8.48)\u003c/p\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"72\"\u003e\n\u003cp\u003e\u0026lt;\u003cstrong\u003e0.001\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003e*\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 59px;\"\u003e\n\u003ctd style=\"height: 59px;\" width=\"96\"\u003e\n\u003cp\u003eMarital status\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"120\"\u003e\n\u003cp\u003eunmarried\u003c/p\u003e\n\u003cp\u003eMarried\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"90\"\u003e\n\u003cp\u003e145(35.45)\u003c/p\u003e\n\u003cp\u003e90(22.00)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"90\"\u003e\n\u003cp\u003e44(10.76)\u003c/p\u003e\n\u003cp\u003e130(31.79)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"132\"\u003e\n\u003cp\u003e\u0026nbsp;4.76(3.092, 7.32)\u003c/p\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"126\"\u003e\n\u003cp\u003e3.81(2.02, 7.19)\u003c/p\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"72\"\u003e\n\u003cp\u003e\u0026lt;\u003cstrong\u003e0.001\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003e*\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 59px;\"\u003e\n\u003ctd style=\"height: 59px;\" width=\"96\"\u003e\n\u003cp\u003eDuration of pop\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"120\"\u003e\n\u003cp\u003e\u0026gt;2 year\u003c/p\u003e\n\u003cp\u003e\u0026le; 2year\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"90\"\u003e\n\u003cp\u003e200(48.9)\u003c/p\u003e\n\u003cp\u003e35(8.56)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"90\"\u003e\n\u003cp\u003e51(12.47)\u003c/p\u003e\n\u003cp\u003e123(30.07)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"132\"\u003e\n\u003cp\u003e13.78(8.48,22.39)\u003c/p\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"126\"\u003e\n\u003cp\u003e8.8(4.81, 16.11)\u003c/p\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"72\"\u003e\n\u003cp\u003e\u0026lt;\u003cstrong\u003e0.001\u003c/strong\u003e\u003cstrong\u003e*\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 83px;\"\u003e\n\u003ctd style=\"height: 83px;\" width=\"96\"\u003e\n\u003cp\u003eIncome level\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"120\"\u003e\n\u003cp\u003e\u0026le; 2000 birr\u003c/p\u003e\n\u003cp\u003e\u0026gt;2000-4000 birr\u003c/p\u003e\n\u003cp\u003e\u0026ge; 4000 birr\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"90\"\u003e\n\u003cp\u003e198(48.41)\u003c/p\u003e\n\u003cp\u003e11(2.69)\u003c/p\u003e\n\u003cp\u003e26(6.36)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"90\"\u003e\n\u003cp\u003e71(17.36)\u003c/p\u003e\n\u003cp\u003e25(6.11)\u003c/p\u003e\n\u003cp\u003e78(19.07)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"132\"\u003e\n\u003cp\u003e8.36(4.97, 14.07)\u003c/p\u003e\n\u003cp\u003e1.32(0.57, 3.04)\u003c/p\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"126\"\u003e\n\u003cp\u003e7.48(3.67, 15.24)\u003c/p\u003e\n\u003cp\u003e1.54(0.51, 4.65 )\u003c/p\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"72\"\u003e\n\u003cp\u003e\u0026lt;\u003cstrong\u003e0.001\u003c/strong\u003e\u003cstrong\u003e*\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e0.439\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 59px;\"\u003e\n\u003ctd style=\"height: 59px;\" width=\"96\"\u003e\n\u003cp\u003eResidency\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"120\"\u003e\n\u003cp\u003eRural\u003c/p\u003e\n\u003cp\u003eUrban\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"90\"\u003e\n\u003cp\u003e203(49.63)\u003c/p\u003e\n\u003cp\u003e32(7.82)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"90\"\u003e\n\u003cp\u003e101(24.70)\u003c/p\u003e\n\u003cp\u003e73(17.85)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"132\"\u003e\n\u003cp\u003e4.58(2.83, 7.40)\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp; 1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"126\"\u003e\n\u003cp\u003e1.87(0.908, 3.87)\u003c/p\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"72\"\u003e\n\u003cp\u003e0.089\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 59px;\"\u003e\n\u003ctd style=\"height: 59px;\" width=\"96\"\u003e\n\u003cp\u003eParity\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"120\"\u003e\n\u003cp\u003e\u0026ge; 7\u003c/p\u003e\n\u003cp\u003e4-6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"90\"\u003e\n\u003cp\u003e195(47.68)\u003c/p\u003e\n\u003cp\u003e40(9.78)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"90\"\u003e\n\u003cp\u003e100(24.45)\u003c/p\u003e\n\u003cp\u003e74(18.09)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"132\"\u003e\n\u003cp\u003e3.6(2.29, 5.68)\u003c/p\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"126\"\u003e\n\u003cp\u003e1.41(0.614, 3.26)\u003c/p\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 59px;\" width=\"72\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 83px;\"\u003e\n\u003ctd style=\"height: 83px;\" width=\"96\"\u003e\n\u003cp\u003eTransport accessibility\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"120\"\u003e\n\u003cp\u003eNever\u003c/p\u003e\n\u003cp\u003eRarely\u003c/p\u003e\n\u003cp\u003eConstantly\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"90\"\u003e\n\u003cp\u003e110(26.9)\u003c/p\u003e\n\u003cp\u003e48(11.73)\u003c/p\u003e\n\u003cp\u003e77(18.83)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"90\"\u003e\n\u003cp\u003e35(8.56)\u003c/p\u003e\n\u003cp\u003e59(14.42)\u003c/p\u003e\n\u003cp\u003e80(19.56)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"132\"\u003e\n\u003cp\u003e3.26(1.99, 5.34)\u003c/p\u003e\n\u003cp\u003e0.84(0.51, 1.38)\u003c/p\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"126\"\u003e\n\u003cp\u003e1.62(0.73, 3.57)\u003c/p\u003e\n\u003cp\u003e0.55(0.24, 1.23)\u003c/p\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"72\"\u003e\n\u003cp\u003e0.247\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 83px;\"\u003e\n\u003ctd style=\"height: 83px;\" width=\"96\"\u003e\n\u003cp\u003eEducational status\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"120\"\u003e\n\u003cp\u003eNon-educated\u003c/p\u003e\n\u003cp\u003ePrimary\u003c/p\u003e\n\u003cp\u003eSecondary and above\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"90\"\u003e\n\u003cp\u003e148(36.20)\u003c/p\u003e\n\u003cp\u003e68(16.62)\u003c/p\u003e\n\u003cp\u003e19(4.64)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"90\"\u003e\n\u003cp\u003e56(13.70)\u003c/p\u003e\n\u003cp\u003e93(22.73)\u003c/p\u003e\n\u003cp\u003e25(6.11)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"132\"\u003e\n\u003cp\u003e3.47(1.77, 6.80)\u003c/p\u003e\n\u003cp\u003e0.96(0.49, 1.88)\u003c/p\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"126\"\u003e\n\u003cp\u003e0.39(0.13, 1.16)\u003c/p\u003e\n\u003cp\u003e0.77(0.26, 2.28)\u003c/p\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" width=\"72\"\u003e\n\u003cp\u003e0.253\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*Significant at P\u0026lt;0.001\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study showed that the overall poor quality of life among women who had pelvic organ prolapse was 57.5% (95%CI: 52.5, 62.3). This means that more than half of women with POP have a poor quality of life. This implicated that; although pelvic organ prolapse is a benign case, it highly influenced the quality of life of women. This finding is in line with a study conducted in France 54.5%(Christian Chauvin, \u003cspan class=\"CitationRef\"\u003e2012\u003c/span\u003e); Pakistan 60.8% (Jokhio, Rizvi, \u0026amp; MacArthur, 2020), and Slovakia 52.8% (Svihrova et al., \u003cspan class=\"CitationRef\"\u003e2014\u003c/span\u003e). This may be due to, although the quality of life of women with POP varies from country to country based on economic level, lifestyle, educational level, and culture, the most common predominant risk factors for worsening QoL of women are pelvic organ prolapse symptoms (Davila et al., \u003cspan class=\"CitationRef\"\u003e2006\u003c/span\u003e; Fritel et al., 2009).\u003c/p\u003e\n\u003cp\u003eOn another side, it is higher than a study conducted in Uganda 45.5% (Kayondo et al., \u003cspan class=\"CitationRef\"\u003e2021\u003c/span\u003e); Ghana 39.4%(Wusu-Ansah \u0026amp; Opare-Addo, 2008). This difference may be due to there being QoL domains and item differences, and there were sample size differences.\u003c/p\u003e\n\u003cp\u003eIn addition, this study showed that the quality of life of women with POP was significantly associated with the stages of the prolapse; stages III and IV were worse, the quality of life. This finding is supported by studies conducted in South Africa(Brandt \u0026amp; van Vuuren, 2019), Taiwan(Manchana \u0026amp; Bunyavejchevin, \u003cspan class=\"CitationRef\"\u003e2010\u003c/span\u003e), Thailand(Hatthanirun P, 2015), Nepal(Shrestha et al., 2015), USA(Jelovsek \u0026amp; Barber, \u003cspan class=\"CitationRef\"\u003e2006\u003c/span\u003e), Italy(Digesu et al., \u003cspan class=\"CitationRef\"\u003e2003\u003c/span\u003e), and London(Digesu et al., \u003cspan class=\"CitationRef\"\u003e2005\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003eThis may be because, as the prolapse progresses secondary consequences include decubitus ulcers, bowel symptoms, urinary symptoms, abdominal, and vaginal symptoms that worsen the quality of life of women(Digesu et al., \u003cspan class=\"CitationRef\"\u003e2005\u003c/span\u003e; Shrestha et al., 2015; Wusu-Ansah \u0026amp; Opare-Addo, 2008).\u003c/p\u003e\n\u003cp\u003eMoreover, this study showed that there was a significant association between the quality of life of women with POP and longer durations of prolapse. This finding is supported by studies conducted in Pakistan(Jokhio et al., \u003cspan class=\"CitationRef\"\u003e2020\u003c/span\u003e), France(Fritel et al., 2009), and Bangladesh(Imoto, Sarker, Akter, Matsuyama, \u0026amp; Honda, 2021). This may be because, as the duration of the disease increased, there was progressive disability. In addition, as the duration of the prolapse increased, there were leads advanced stages of prolapse caused a symptomatic prolapse that worsens women\u0026rsquo;s health conditions(Fontenele et al., \u003cspan class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003eConsistently, this study showed that the low-income level of women with POP was strongly associated with a poor quality of life. This finding is supported by studies conducted in Bangladesh(Imoto et al., 2021) and South Africa(Brandt \u0026amp; van Vuuren, 2019). This may be because women who have low income with pelvic organ prolapse have incapacity of access to education, better control over a personal lifestyle, accessibility to housing, and environmental safety; this condition further worsens their quality of life.\u003c/p\u003e\n\u003cp\u003eFurthermore, this study showed that women being unmarried (divorced, widowed) was strongly associated with poor quality of life of women. This finding is in line with studies conducted in Bangladesh(Imoto et al., 2021). This implicated, in fact being in a relationship, could be considered a buffer mechanism against psychological illnesses, reducing the likelihood of developing depressive symptoms, and isolation(Brandt \u0026amp; van Vuuren, 2019). In addition, loneliness women with pelvic organ prolapse had double responsibility to lead their life; this condition could be further worse for their lives.\u003c/p\u003e\n\u003cp\u003eMoreover, this study showed that menopause women were strongly associated with poor quality of life. This finding is supported by studies conducted in Turkey(Vurgec \u0026amp; Beji, \u003cspan class=\"CitationRef\"\u003e2018\u003c/span\u003e). This could be due to as the women entered the menopausal stage there were physiological changes resulting in menopausal symptoms and worsening of the prolapse, which is a double burden to worse the quality of life of women(Charles R. B. Beckmann, 2010)\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eMore than half of women with pelvic organ prolapse had a poor quality of life. Stage III/IV prolapse, longer duration of prolapse, low-income level, menopausal period, and unmarried women (widowed, divorced) are statistically significant factors for the quality of life of women with POP. Therefore Ethiopian Ministry of health with their stakeholders should focus on develop an early detection and treatment strategy, Offering the possibility of early diagnosis and treatment for women that has been hidden in the community, financially and psychological support to women with POP to prevent further impairment of their quality of life\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAOR--Adjusted Odds Ratio, OPD-- Outpatient Department, POP --Pelvic Organ Prolapse, QoL-- Quality of Life, SNNPR--Southern Nations, Nationalities, and Peoples Region\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e: Ethical clearance was obtained from the Institutional Review board of College Health Science; Debre Markos university (study protocol number-159/2022). Then, officials at different levels in the hospitals were communicated through letters from College of Medicine and Health Science. Then, informed written consent from all participants were obtaind (while for women who cannot read and write legalized authorized representative was considered). Confidentiality of the information was secured throughout the study process. Finally, the results of study was used only for study purpose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e: Not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e: The datasets analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interest\u003c/strong\u003e: the authors declare that they have no competing interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThere were no external organizations that funded this research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contribution\u003c/strong\u003e: ZT developed the project. ZT, BT, MA, TG, and AB participated in the methodology, data analysis and developing the initial drafts of the manuscript and revising subsequent drafts. ZT and MA prepared the final draft of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment:\u0026nbsp;\u003c/strong\u003eWe would like to thank Debre Markos University College of Medicine and Health Science to support this research project. The authors would also like to extend their gratitude southern region public referral hospitals, study participants, data collectors, and supervisors for their valuable contribution.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBadacho, Abebe Sorsa, Lelu, Mengistu Auro, \u0026amp; Gelan, Zegeye. (2020). Uterine prolapse and associated factors among reproductive age women in Dawro zone, southwest Ethiopia: a community based cross sectional study. \u003c/li\u003e\n\u003cli\u003eBarber, Matthew D. (2016). 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Southern nations, Ntionalities and peoples Region \u003cem\u003ehttps://en.wikipedia.org/wiki/Southern_Nations,_Nationalities,_and_Peoples%27_Region\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eWilkins, Maggie F, \u0026amp; Wu, Jennifer M. (2016). Epidemiology of pelvic organ prolapse. \u003cem\u003eCurrent Obstetrics and Gynecology Reports, 5\u003c/em\u003e(2), 119-123. \u003c/li\u003e\n\u003cli\u003eWusu-Ansah, Osei K, \u0026amp; Opare-Addo, Henry S. (2008). Pelvic organ prolapse in rural Ghana. \u003cem\u003eInternational Journal of Gynecology \u0026amp; Obstetrics, 103\u003c/em\u003e(2), 121-124. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Debre Markos University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"pelvic organ prolapse, quality of life, associated factor, Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-2409050/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2409050/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003ePelvic organ prolapse is an important public health issue influences millions of adult women\u0026rsquo;s lives; through limitations on physical, social, and sexual activities as well as psychological distress. However, there were no reports on the quality of life for women with pelvic organ prolapse in Ethiopia. Therefore this study amid to assess the magnitude of quality of life and its associated factors among women diagnosed with pelvic organ prolapse in Gynecology outpatient department Southern Nations, Nationalities, and Peoples region public referral hospitals; Ethiopia.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e \u003cp\u003eAn institutional-based cross-sectional study was conducted in Southern Nations, Nationalities, and Peoples region of public referral hospitals from May1-July 4, 2022 among 419 diagnosed women with pelvic organ prolapse. A validated tool was used to collect the data. The collected data were entered into EPI data version 3.1 and analyzed using the Statistical Package for Social Sciences. Bivariable and multivariable logistic regression was computed. The p-value of \u0026lt;\u0026thinsp;0.05 was used to declare the final statistical significance.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e \u003cp\u003eA total of 409 women with pelvic organ prolapse were included in the study, giving a response rate of 97.6%. The overall poor quality of life was 57.5%. Regarding the quality of life domains; personal relationships (73.6%), were highly affected, and sleep/energy (24.2%) was the least affected domain. Stage III/IV prolapse (AOR\u0026thinsp;=\u0026thinsp;4.61, 95% CI: 2.51, 8.48), menopause (AOR\u0026thinsp;=\u0026thinsp;3.59, 95% CI: 1.85, 6.97), unmarried women(widowed, divorced) (AOR\u0026thinsp;=\u0026thinsp;3.81, 95% CI: 2.02, 7.19), low-income level (AOR\u0026thinsp;=\u0026thinsp;7.48, 95% CI: 3.67, 15.24), and longer duration of prolapse (AOR\u0026thinsp;=\u0026thinsp;8.8, 95% CI: 4.81, 16.11), were significantly associated with poor quality of life.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eMore than half of women with pelvic organ prolapse had a poor quality of life. Stage III/IV prolapse, longer duration of prolapse, low-income level, menopause women, and unmarried women are statistically significant factors for the quality of life of women with POP. Therefore, Ethiopian Ministry of health with their stakeholders should develop an early detection and treatment strategy, and financial support for women with pelvic organ prolapse.\u003c/p\u003e","manuscriptTitle":"Quality of life and its associated factors among women diagnosed with pelvic organ prolapse in Gynecology outpatient department Southern Nations, Nationalities, and Peoples region public referral hospitals, Ethiopia 2022","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-01-04 21:02:19","doi":"10.21203/rs.3.rs-2409050/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0e52d34d-92ef-4767-a408-d30e7dc71ce0","owner":[],"postedDate":"January 4th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":17935259,"name":"Obstetrics \u0026 Gynecology"}],"tags":[],"updatedAt":"2023-01-04T21:02:19+00:00","versionOfRecord":[],"versionCreatedAt":"2023-01-04 21:02:19","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-2409050","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2409050","identity":"rs-2409050","version":["v1"]},"buildId":"7rjqhiLT3MXkJMwkYKINL","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}