Reviewer ’s report  
 
Title: Anatomical landm arks of the intra -pelvic side -wall as so urces of pain in women with and 
without pregnancy -related chronic pelvic pain after childbirth: a descriptive study  
 
Version: 0 Date: 21 Jun 2017  
 
Reviewer: Ying Cheong  
 
Reviewer's report:  
 
This paper aims to compare pain intensity provided from anatomical landmarks of the pelvic side 
wall in women with pregnancy related CPP and women without such pain. The study compared 
the pain intensities reported on 13 anatomical landmarks of 36 parous w omen with CPP and 29 
without CPP. They reported characteristic differences in anatomically provoked CPP pain 
intensity reported in women with CPP compared to those without. The way the study has been 
described and laid out is rather confusing. The results were also not particularly specific to the 
objective and outcomes described at the start. It is also unclear if the authors meant the 
participants were pregnant and had CPP or they had previous pregnancies and currently not 
pregnant and have CPP. It became  apparent that it may be the latter but the authors need to 
clarify this.  
 
 
 
The authors went on to report that the pain intensity reported by the women with CPP in relation 
to the 13 intra -pelvic landmarks were higher compared to controls. They have descri bed a 
physical examination which they claim has not been generally used, could be used clinically to 
discriminate patients with CPP and those without.  
 
 
 
Unfortunately I do not think the study has shown this. The study showed that women with CPP 
(who had be en previously pregnant) were more sensitive (expressed as pain intensity)at the 13 
anatomical site examination. I think there is value in perhaps describing this observation, but the 
conclusion will have to be adjusted. Perhaps something along the lines of  'Parous women with 
CPP have a heightened pain intensity over 13 anatomical landmarks during pelvic examination 
compared with those without CPP'? If the authors wish to provide some comment on parity, then 
a group who is nulliparous would be required as co mparison. Otherwise there cannot be any 
claim on the impact of parity. 'Intra -pelvic examination' is a rather strange way of describing a 
'vaginal/pelvic or bimanual examination'. It implies that it could be 'extra -pelvic'? Simpler terms 
also in the title will make this piece of work more readable.  
 
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
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 manus cript or would you recommend an 
additional statistical revi ew? 
If an additional statistical review is recommended, please speci fy 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 manusc ript: 
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following qu estions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat 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 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 i nterests 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.  
 
none 
 
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