Reviewer ’s report  
 
Title: The degree of bother and healthcare seeking behaviour in women with symptoms of pelvic 
organ prolapse from a developing Gulf country  
 
Version: 0 Date: 24 May 2017  
 
Reviewer: Heidi W. Brown  
 
Reviewer's report:  
 
Thank you for addressing this very important research question about help -seeking for pelvic 
organ prolapse among women in UAE; very little is known about this question and your paper 
makes a valuable contribution. I have the following suggestions:  
1) Pleas e use consistent terminology throughout - you use the words genital organ prolapse, 
pelvic floor organ prolapse, and POP. POP usually stands for pelvic organ prolapse, not 
pelvic floor organ prolapse.  
 
2) The introduction could be significantly revised. You  did a good study for excellent reasons - 
we don't know much about POP and help -seeking for POP in UAE women, and used a 
survey of women presenting for general gynecologic care to learn more about this topic. In 
other societies, the following reasons have been identified as factors that can impact help 
seeking - embarrassment, financial factors, limited knowledge, social / family support, time 
(not mentioned in your paper but shown in multiple studies), competing other medical 
priorities (shown in other stu dies but not mentioned in yours). We wanted to understand 
help-seeking and associated factors in Emirati women.  
 
3) Your introduction mentions lots of shortfalls in the overall literature that aren't addressed by 
your study - for example, lack of population -based studies (not exactly true, but no matter), 
and lack of studies addressing Asian women. I would remove lines 47 -54 page 5 completely -
- your study is limited by not being population -based so you don't want to say in the 
introduction that you did this  study because other studies were not population -based. I would 
remove the line about not addressing Asian women (57 -58) page 5.  
 
3) Page 6, line 32: interviewer -administered self -reported is confusing. I suspect that trained 
interviewers verbally administe red the questionnaire to women - is that correct? If so, were 
language barriers an issue? Do all women in UAE speak the same language? Did you limit 
the study to participants who only spoke one language? Were interviewers women? Men? 
Both? That could impac t the results.  
 
4) Page 10, lines 34 -40 - Please revise this sentence to say that women across various nations 
appear to be bothered and socially impacted by POP. You did not directly compare bother of 
women in UAE with women in the US and Nepal, so the con clusion that impact is not 
different across nations is not warranted by the data.  
 
5) Page 10, lines 58 - Page 11, lines 18 - The introduction of this information would be nice in 
the introduction of your paper, along with the other factors listed in comment #2 above. 
Then, you can use the discussion to frame how your findings are similar  to and different from 
those noted in other societies.  
 
6) Page 13, top paragraph: The following potential limitations were not mentioned and should 
be: Interviewer -administered versus self administered? Limitations of assessing barriers to 
help-seeking am ong a population of women seeking other services?  
 
7) Page 13, lines 49 -60 - What do you suggest messages should be for your society, based on 
findings from your paper? How do you propose to target shyness and embarrassment?  
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 sp ecify 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.  
 
Yes 
 
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  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary 
from an  organisation that may in any way gain or lose financially from the 
publication of this  manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares  in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of 
the manuscript?  
 
4. Have you recei ved reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
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