Workplace challenges faced by female surgeons in Asia have not been as extensively studied as those in Western countries. In traditionally patriarchal Asian societies, few women surgeons reach leadership positions, but the reasons for their success remain underexplored. This study aimed to examine how women surgeon leaders in South, East, and Southeast Asia navigated family related challenges while balancing career demands. Female surgeons from South, East, and Southeast Asia with institutional, national, or international leadership roles were recruited through purposive sampling to ensure regional representation. Semi-structured interviews were conducted in English either online or face to face, and thematic analysis was applied. Themes were identified and refined through consensus, with analyses supported by ATLAS.ti software. Thirty-one interviews were conducted, involving 7 (23%) South Asian surgeons, 5 (16%) East Asian surgeons, and 19 (61%) Southeast Asian surgeons. Six main themes were identified: familial roles and expectations, marriage and family life, pregnancy, breastfeeding, childcare, and balance between career and family. Female surgeons juggled multiple familial roles while pursuing a demanding career. Pregnancy, breastfeeding, and childcare were integrated with training and surgical commitments, many with great difficulty. Some acknowledged that workplace commitments contributed to singlehood, divorce, or delayed family planning. Nearly all emphasized prioritizing family over career. Family related challenges significantly impact career decisions and pathways for female surgeons in Asia. As more women enter the surgical workforce, targeted strategies are needed to ensure equity in opportunities.

The recent study by Basiouny et al. on transverse perineal support for obstructed defecation syndrome highlights the importance of objective assessment of pathological perineal descent. We wish to provide a historical and methodological clarification regarding the measurement device used in the study. The instrument illustrated as a "perineometer" may correspond to the previously described Perineocaliper[®], a device developed for the clinical measurement of perineal descent. Although objective measurement of perineal descent was first introduced by Henry and Parks using a different instrument, the Perineocaliper represents a distinct development. In addition, the term perineometer has traditionally been used in urogynecology for devices measuring pelvic floor muscle contraction strength. Accurate identification and terminology of measurement devices may improve methodological clarity and facilitate comparison between studies.