Reviewer’s report
Title: 
Evaluation and management of obstetric genital fistulas treated at a pelvic floor centre in Germany
Version: 
0 
Date: 
30 Nov 2020
Reviewer's report:
This is a large series report of the outcome of obstetric genital fistulas treated in a special center of pelvic
floor. It provided a comprehensive data regarding an uncommon complication after birth in a developed
country. However, there are several unclear statements shown in the current manuscript. The following
points are specifically needed to be clarified:
1. In the section of results, page 8 lines 201-203, the authors write that "Seven RVF(Recto-Vagina
Fistula)s were successfully closed simultaneously with the subsequent caesarean section; in two women,
surgery was performed following a subsequent vaginal delivery". It seemed that most cases underwent
caesarean section instead of vaginal delivery. So, please explain more specifically how the authors
concluded that "For the first time, pregnancy-related changes in the vaginal wall were used to optimize the
success rate of fistula closure."
2. RVF 
closure was achieved in 88.65% (26/29) as described in the result. Please show the outcome and
subsequent management of the 3 who failed. 
3. The authors concluded that "The choice of OGF repair methods should be tailored to the underlying
pathology, the type of previous repair, the patients' wishes and the surgeon's experience." But it seemed
too simple to be taken, please summarize the guidelines more specifically for the choice of repair of OGF
that authors might suggest from their experience. 
Overall, the report is too lengthy. Some of the data were repetitively mentioned in the context. Please
condense the context to make the point. 
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