International Urogynecology Journal

, Volume 30, Issue 1, pp 149–156 | Cite as

Validation of the Amharic version of the Pelvic Organ Prolapse Symptom Score (POP-SS)

  • Tadesse BelaynehEmail author
  • Abebaw Gebeyehu
  • Mulat Adefris
  • Guri Rortveit
  • Tinsae Genet
Original Article


Introduction and hypothesis

We aimed to translate and culturally adapt the Pelvic Organ Prolapse Symptom Score (POP-SS) into Amharic and evaluate its psychometric properties.


We followed an intercultural adaptation procedure to translate and adapt the POP-SS. One hundred and eighty-six women with POP symptoms completed the Amharic POP-SS and Prolapse Quality of Life (P-QoL) questionnaires. All women were examined using a simplified Pelvic Organ Prolapse Quantification (SPOP-Q) system and were divided into four groups based on the POP-Q scores as stage 1, 2, 3, and 4. Internal consistency and test–retest reliability were determined using Cronbach’s alpha and the intraclass correlation coefficient (ICC), respectively. Criterion validity was assessed against the SPOP-Q stage and the P-QoL scale. Furthermore, we tested construct validity using exploratory factor analysis.


The POP-SS score was successfully translated and achieved good content validity. It had high internal consistency (Cronbach’s alpha = 0.86) and test–retest reliability (ICC = 0.81; p < 0.001). There was a statistically significant difference among four groups of stages in POP-SS score. and women with stage 3 had the highest median score (Kruskal-Wallis test; p < 0.05). The POP-SS score was also significantly correlated with the P-QoL score (Spearman’s correlation coefficient = 0.28, p < 0.001). The exploratory factor analysis identified two factors, namely, physical symptoms and evacuation symptoms.


The POP-SS scale was successfully translated to Amharic and appears reliable and valid for women with symptoms of POP. However, further studies are needed to evaluate its responsiveness.


Pelvic organ prolapse Reliability Validity Amharic validation Ethiopian 



Intraclass correlation coefficient


Content validity index


Quality of life


Pelvic organ prolapse


Prolapse Quality of Life


Pelvic Organ Prolapse Symptom Score


Simplified Pelvic Organ Prolapse Quantification



The authors acknowledge all study participants. We thank Professor Suzanne Hagen, the original developer of the tool, for allowing us to translate the instrument into our language. We also would like to express our heartfelt thanks to the research assistants and the expert panel who provided input to this study.


This work was supported by a grant, R.No: O/VP/RCS/05/216/2017, from the University of Gondar. The University was not involved in the design, conduct, analysis, or interpretation of the study or review or approval of the manuscript.

Compliance with ethical standards

Conflicts of interest



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Copyright information

© The International Urogynecological Association 2018

Authors and Affiliations

  1. 1.Institute of Public Health, College of Medicine and Health SciencesUniversity of GondarGondarEthiopia
  2. 2.Department of Gynecology and Obstetrics, School of MedicineUniversity of GondarGondarEthiopia
  3. 3.Research Group for General Practice, Department of Global Public Health and Primary CareUniversity of BergenBergenNorway
  4. 4.Research Unit for General PracticeUni Health, Uni ResearchBergenNorway

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