Reviewer’s report
Title: 
Novel insight into the correlation between hernia orifice of cystocele and
lower urinary tract function: a pilot study
Version: 
2 
Date: 
22 Feb 2022
Reviewer's report:
Dear Respectable Editor 
Thank you to give me the opportunity to review the article entitled (Novel
insight into the correlation between hernia orifice of cystocele and lower urinary
tract function: a pilot study)
The study attempted to further elucidate the correlation between pelvic organ
prolapse (POP) and voiding dysfunction (VD) through a new subgroup
classification using cystoscopy.
The authors reviewed clinical records of 49 women who underwent cystocele
repair. All patients were scheduled for laparoscopic sacrocolpopexy,
preoperatively underwent uroowmetry and postvoid residual urine volume
(PVR) measurement and completed pelvic floor function questionnaires. Bladder
examination by cystoscopy was additionally performed using the lithotomy
position with the Valsalva maneuver.
The study concluded that the new bladder defect classification based upon hernia
orifice location was associated with lower urinary tract function. Posterior wall
hernia presence caused significant voiding function deterioration. This new
subgroup classification, which can more clearly identify and indicate bladder
function, is also comparable among patients.
The authors used a structured abstract and informative title 
In the introduction section, the authors mentioned the magnitude of the problem
[cystocele is the most commonly seen among all the conditions associated with
pelvic organ prolapse. High-grade cystocele is generally associated with lower
urinary tract dysfunction, such as voiding dysfunction (VD) and stress urinary
incontinence (SUI)] which justify the aim of their study. 
The methodology and results are clear supported by the tables and figures.
In the discussion section the authors compared their findings with other authors
findings.
In addition, they mentioned the limitation of their study and they suggested a
large future studies to support their findings.
The authors reached clear conclusion reflecting their results and they used
relevant references. 
Finally, the study is scientifically valid and technically sound pilot study and can
be accepted for publication. 
Regards 
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes