Title: Chronic endometritis increases the recurrence of endometrial polyps in premenopausal
women after hysteroscopic polypectomy
Version: 0 Date: 20 Oct 2022
Reviewer's report:
Comments to the editor
Thank you for the opportunity to review the article titled: Chronic endometritis increases the
recurrence of endometrial polyps in premenopausal women after hysteroscopic polypectomy
In this study, the authors have evaluated the the recurrence of endometrial polyps in
premenopausal women after hysteroscopic polypectomy.They have reached a conclusion
that chronic endometritis was a harmful factor for the recurrence of EPs in premenopausal
women after hysteroscopic polypectomy.. there are some grammatical errors Throughout the
manuscript. Thus, I think that this paper needs some adjustments and corrections that I have
mentioned below, otherwise I believe that it contains important scientific data which are valuable
for the field.
Specific comments
1. Introduction: the author did not link between from pathophysiological point of view how can
chronic endometritis be linked to polyps which should be explained extensively
2. Materials and methods for patients and sample collection:
• there are a lot of detrimental pitfalls in methodology :
The author did not mentioned how many patients did not come for follow up within the one year
frame logically there should be some missing data
line 110 inflammatory disease  in methodology) what kind of inflammatory disease ?the author
should explain
regarding exclusion criteria the author only exclude endometriosis and previous polypectomy
what about other confounding as PCOS , hypertension diabetes ,obesity ,tamoxifen therapy,
location ,no and size of polyps and age of patient
line 133 the author mentioned TVU used for follow up but the author did not mention the type
of TVU weather 2D or 3D and the accuracy of US in detecting polyp what is the sensitivity
and specificity what about missing polyps by TVU that can only detected by hysteroscopy with
higher sensitivity and specificity. My advice to use saline sonography to increase the sensitivity
of TVU in screening  intra cavitory lesion
did the author confirm the diagnosis of polyp by histopathology and to exclude malignancy ?
as in methodology the answer is NO.
the author did not explain thoroughly how the diagnosis of chronic endometritis were done as
its regarded as one of the main corners of this study
• Also, there were multiple missing points in the methodology.
3. Result:
4. Discussion:
• In general The discussion is very short and inconclusive, it needs to be rewritten and well
correlated with other similar studies.
Line 222     CE can be changed by treatment of antibiotic please can you explain in details what
types of drugs duration of treatment and add references
5. Conclusion: the author concluded that In conclusion, this study demonstrated that CE
was a harmful factor for the recurrence of EPs in premenopausal women after hysteroscopic
polypectomy. Thus, routine screening and treatment are needed for CE. Multiple EPs also
contributed to polyp recurrence. The role of CE in the recurrence of EPs needs to be further
confirmed by randomized trials with a large sample size, and the potential mechanism of the
harmful effects of CE remains to be investigated
6. Please the paper needs an English proofreading