Reviewer ’s report  
 
Title:  Life after pelvic organ prolapse surgery: A qualitative study in Amhara region, Ethiopia  
 
Version: 0 Date: 08 Jan 2018 
 
Reviewer:  Antonio  Cianci  
 
Reviewer’s report:  
 
I was pleased to review the Research Article " Life after pelvic organ prolapse surgery: A 
qualitative study in Amhara region, Ethiopia" (BMWH -D-17-00203). In general, this is a well -
written manuscript that poses an interesting question about women's experiences after pelvic 
organ prolapse surgery. I a ppreciated the methodology used in this study, but reference list could 
be further improved.  
 
 
In general, I have only a few comments and suggestions to the authors:  
 
* Proof -reading by native English speaker is mandatory, in order to improve readability 
and correct several typos.  
 
* I appreciated the novelty and importance of the topic. I would recommend to specify 
which management for pelvic organ prolapse you applied for women of Ethiopian 
community and discuss your management in comparison to other strate gies. I suggest 
mentioning these studies about this topic: Arch Gynecol Obstet. 2016 Jan;293(1):125 -31. 
doi: 10.1007/s00404 -015-3820 -0; Int Urogynecol J. 2011 Dec;22(12):1535 -41. doi: 
10.1007/s00192 -011-1481 -5; Int Urogynecol J. 2011 Dec;22(12):1535 -41. do i: 
10.1007/s00192 -011-1481 -5; Int Urogynecol J. 2011 Jun;22(6):739 -42. doi: 
10.1007/s00192 -011-1364 -9.  
 
* Quality of life and sexuality are the main goals for prolapse surgery. The prevalence of 
prolapse is major after menopause in the general population b ecause one of the risk 
factors is estrogen deficiency, for this reason a local therapy with estrogens can speed up 
the tissue healing after vaginal surgery and improve quality of life and sexuality. In the 
group of recruited Ethiopian women the mean age wa s 43.3 and some of them are not in 
menopause. Please specify if women recruited underwent any local therapy before or 
after surgery for prolapse and compare the results about quality of life and sexuality to 
those described in literature. I suggest mention ing this article about the topic: Menopause. 
2017 Aug;24(8):900 -907. doi: 10.1097/GME.0000000000000851.  
 
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.  
 
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 wri tten English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being publish ed 
 
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 o r 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 received 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' below. If your reply is yes to any, please give details 
below.  
 
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