Reviewer’s report
Title: 
R ectal – V aginal pressure interval during Vasalva among patients with
symptomatic rectocele: A cross-sectional study in patients with pelvic organ
prolapsed
Version: 
0 
Date: 
14 Mar 2021
Reviewer's report:
Pelvic organ prolapsus is a common condition in women. Prolapsus is related to
several anatomical abnormalities, such as rectocele. The pathogenesis of this
condition is very complex. A better understanding of symptomatic rectocele
pathogenesis could help in patient selection, thus enabling symptom relief post-
surgery. This cross-sectional research investigates the relationship between rectal
- vaginal pressure and symptomatic rectocele among patients with pelvic organ
prolapse.
According to this research; Age and elevated rectal - vaginal pressure interval
were found to be the risk factors for symptomatic rectocele among pelvic organ
prolapse. The authors found a cut-off point of the high-pressure interval (A
rectal-vaginal pressure interval of 27.5 cm H2O). Apical prolapse could be a
protective factor of symptomatic rectocele, according to this clinical study.
Patient groups in the study were well designed, and statistical methods were well
applied. Patient inclusion and exclusion criteria are well described. References of
the manuscript are current. Adequate sample size, reliable diagnosis method, and
using a blind method are the article's favourable speciliaties. 
As a conclusion; the current study can contribute to the literature. I think this
manuscript can be accepted after minor spelling and grammar mistakes. 
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
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Are the methods sufficiently described to allow the study to be repeated?
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from apparent manipulation?
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