Reviewer’s report
Title: 
Clinical relevance of routine transvaginal ultrasound in women referred
with pelvic organ prolapse
Version: 
1 
Date: 
12 Jun 2020
Reviewer's report:
Thanks very much for submitting this manuscript. This is a interesting topic to
look into. 
I would like to have the following comment:
1. The primary outcome of this paper is to look into the incidental finding of
routine TVS in women referred for POP. And all the incidental finding were
benign pathology. However, more detail would be required when reporting extra
procedure / treatment were needed for this group of patient. Please give more
detail how the operation/ 
management changed according to the incidental
finding in Table 2. In case of ovarian pathology, is vaginal BSO a option for
those patients who intended for vaginal hysterectomy? 
2. In the background, may I know where is the reference from ' Only about 6%
of these women have classic prolapse symptoms such as a feeling of bulging, a
heavy feeling, protrusion, pressure or a visible bulge of the vagina' , this figure is
quite surprising. 
3. please add in the actual number of cases rather than presenting all in
percentage in the abstract and also result, this may be difficult to follow which
group of patient authors are referring to. 
4. Please amend Figure 1, as the there should be some major mistakes in the
label of each box that we cannot follow. And the incidental finding were
reported to be all benign, but at the last box, there are 2 cases of malignancy?
This is unclear. 
5. For the conclusion, author mentioned: Transvaginal ultrasound scan was
important to clarify the diagnosis in women referred with 
pelvic organ prolapse, but who had no indication for operation', but what data
from the study support this conclusion? Please elaborate. 
6. Please go through the reference again, eg. from reference 10, what information
or data has show the message of 
'Other studies find 
endometrial screening with ultrasound ineffective to differentiate benignant
findings from malignant findings (9, 10)' ? 
7. what is the meaning of 'extra controls' mean in this paper, extra treatment or
investigations? 
8. I will suggest a proof reading of the language used in the manuscript 
Thank you very much. 
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the
authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional statistical review is recommended, please specify what aspects
require further assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
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