Reviewer’s report
Title: 
Recurrent urethral obstruction secondary to large vulval inclusion cyst: a
remote complication of female genital mutilation: a case report
Version: 
0 
Date: 
03 Jul 2023
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
RELEVANCE - Does this case report make a contribution to medical
knowledge, have educational value, or highlight the need for a change in clinical
practice or diagnostic/prognostic approaches? 
Yes, this report contributes to medical knowledge
CASE DESCRIPTION - Are the details of the case sufficiently well described to
understand the patient's symptoms and course of treatment? 
Yes, the description of the case is sufficient
DIAGNOSIS/INTERPRETATION - Based on the facts presented, are the
diagnosis, interpretation, and course of treatment medically sound?
Yes, the work described is medically sound
DISCUSSION OF THE CASE - Does the discussion appropriately analyse the
importance of the findings and their relevance to future understanding of disease
processes, diagnosis or treatment? Has an adequate literature review pertinent to
the case been included?
No - there are major issues
OVERALL MANUSCRIPT POTENTIAL - Could an appropriately REVISED
version of this work represent a technically sound contribution?
Maybe - with major revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: This is an interesting case that sheds light on the
practice of female genital mutilation and its complications. Authors provide a
clear description of the case and the management and provide a good literature
review of similar cases.
REQUESTED REVISIONS: 
Abstract:
- Line 16 : use "the" instead of "our" in: 
our patient, our hospital
- Line 29 : The cyst was "surgically" removed instead of "easily"
- Line 33: Conclusion: consider revising and using same conclusion at end of the
paper page 5 line 36. 
Background: 
- Line 7: hundred million and 140 million ? which one is correct- need
revision/clarification
- Line 22: Authors may choose to include an updated systemic literature review
on professional attitudes to FGM :
- Zurynski Y, Sureshkumar P, Phu A, Elliott E. Female genital mutilation and
cutting: a systematic literature review of health professionals' knowledge,
attitudes and clinical practice. BMC Int Health Hum Rights. 2015 Dec 10;15:32.
doi: 10.1186/s12914-015-0070-y. PMID: 26652275; PMCID: PMC4676087.
Case:
- 42: "re"assured her 
- Page 4 line 7- 9: UTI was treated according to urine culture? 
Clarify if there is
a specific hospital protocol otherwise omit
- Page 4 line 20: 
clarify the reason patient stayed overnight (typically cyst
surgery can be outpatient) especially uncomplicated cases - authors mentioned it
was easily removed.
Discussion:
- Page 5 line 39-48: how did the authors diagnose her as BOO and not simply
obstruction at the meatus. The case they cite as ref 6 is a true BOO because it
was a prolapsed uretrocele while this case is an external vulval/introital mass.
- Page 5 line 53: renal "failure" not "dysfunction"
- Page 5 line 55- 57 Can omit causes of urine retention- paper focus only on
urinary retention due to obstruction.
Pictures:
- Would be great if authors have a postoperative picture
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