Reviewer ’s report  
 
Title: Gynecological Hysterectomy in Northern Tanzania:  A Cross -Sectional study on the 
Outcomes and Correlation between Clinical and Histological Diagnoses  
 
Version: 0 Date: 06 Apr 2020  
 
Reviewer: Radosa Marc P  
 
Reviewer's report:  
 
Ovarall an intersting study  
 
Abstract / Introduciton:  
 
It seems  hard to imagine for me that hysterectomy is the most common gynecologic procedure, 
judging from my experience this would rather be hystereocsopy / curettage of the uterus.  
 
 
Results / Discussion  
 
Please classify surgical complications in your cohort by usin g the Clavien -Dindo classification 
system for surgical complications. For laparoscopic procedures in gynecologic surgery 
standardized complication rates have been published (Standardised Registration of Surgical 
Complications in Laparoscopic -Gynaecological  Therapeutic Procedures Using the Clavien -
Dindo Classification. Radosa MP et al.,Geburtshilfe Frauenheilkd. 2014 Aug;74(8):752 -758) 
Please compare your standardized complication rate with this reference cohort, since it gives 
readers a good idea of the act ual surgical morbidity of your cohort. Also compare your risk 
factors with risk factors for complications in the aforementioned reference cohort  
 
You describe also cases of pelvic organ prolapse. This pathology is usually not treated with 
hysterectomy unle ss the hysterectomy is performed as part of a prolapse surgery (e.g. 
sacrokolppexie). Please specify on this subject.  
 
Please check your manuscript for orthography and grammar thoroughly since there is a 
considerable number of misspellings and incorrect g rammar use in your manuscript.  
 
Please consider not using judging language (e.g: "good outcome", "correlation was …very 
good"). Rather report results from your study - e.g. xx percent of all patients had no perioperative 
complication; correlation between x  and y was found to be xxx.  
 
In your comment section, I would advice to lay the main focus on complications rates, since this 
appears to be the most interesting part for most of the readers in my opinion.  
 
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 control s? 
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 manus cript or would you recommend an 
additional statistical review?  
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 manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing inter ests, considering the following questions:  
 
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 c ontent 
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 co mpeting interests  
 
I agree to the open peer review policy of the journal. I understan d that my name will be incl uded 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be p osted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal