Reviewer’s report
Title: 
A 36-year-old lady with type three Female Genital Mutilation
(Infibulation) – its long-term complications: a case report and literature review
Version: 
0 
Date: 
11 Jan 2023
Reviewer's report:
The article is an interesting case study, and its important to highlight such
experiences. However, there is a need for some updates, and some clarifications.
The definition of FGM is old, as the revised definition from WHO in 2008 does
not specify that its not cultural reasons , so that can be removed. The point is that
there is no clinical reason. For the typology, I suggest to refer to a WHO
document itself, either when the last revision was done in 2008 (Joint statement
on FGM - reference no 5 in the ref.list - bt needs correction), or the latest
guidelines for medical care after FGM, that WHO published in 2016 (WHO
guidelines on the management of health complications from female genital
mutilation". This reference also relies on a series of systematic reviews of health
complications and clinical management commissioned by WHO, that should be
used as a reference in the article. The descriptions of the typology should thus be
revised accordingly. In addition there are some linguistic challenges that makes
certain issues unclear, for example the reference to menarche 13 years ago,
which I suppose rather meant at age 13. It would also be useful with more
methodological information on how many times the hospital met with the patient
and the time-period for these meetings. On page 5, they mentioned the tissue
stretch for sexual intercourse to be possible, however it seems more common
that the tissue of the infibulated scar is cut or torn open. If the authors have more
information about the woman's fear that she doesn't have a vagina due to the
closure, as infibulation is common in certain groups, for example the Somali and
Affar ethnic groups, thus her genital status should be common among her family
and peers that she could have gotten advice from.
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