Reviewer's report
 Perceived effects on postoperative sexual function for women undergoing supracervical Title:
hysterectomy vs. total abdominal hysterectomy
Authors:
Jyot Saini (js118@is8.nyu.edu )
Edward Kuczynski (kuczye01@med.nyu.edu )
Herbert F. Gretz III (hfgiii@aol.com )
E. Scott Sills (dr.sills@ivf.com )
 4  15 Oct 2001 Version: Date:
 Dr Hatem Mousa Reviewer:
 A paper of limited interest Level of interest:
 Unable to decide on acceptance or rejection until I see revised version Advice on publication:
Comments for authors 
Manuscript " Perceived effects on postoperative sexual function for women undergoing suravaginal 
cervical hysterectomy vs. total abdominal hysterectomy" 
The manuscript by Saini et al., is essentially directed at the debate regarding the effect of preservation 
of the cervix on postoperative sexual function. They have examined the changes in sexual function 
using locally developed questionnaire. They concluded that TAH patients experienced poorer postoperative sexual function. However, it is not supported by their results. The manuscript in its present form, adds little to the literature. I have certain concerns regarding the current state of the 
manuscript: 
Methods: 
1. The authors used a locally developed questionnaire that lacks both internal and external validation. It 
is not clear why they did use previously developed, tested and reported questionnaires. 
2. Recent prospective longitudinal studies that addressed the same issue have used age limit of 45 (1). The authors need to justify the use of 60 as a cut-off level. 
Results: 
1. Demographic details: The authors need to provide information regarding non-response analysis of the two groups. As the two groups have unequal numbers, authors must use median instead of mean and should provide the range for age, length of hospital stay, and uterine mass. 
2 Preoperative sexual function: As the authors stated clearly that the aim of the study is to examine 
postoperative sexual function, I can not see how they will be able to assess current sexual function and preoperative anticipated function at one point of a time. The title for table 3 does not read right. I would expect to see in table three two columns for each group describing actual preoperative sexual function 
and anticipated outcome. 
3. Table 4 and 5: In the method section the authors indicated that they have offered three levels for 
response (better, same, or worse). However, they presented the data including "same and better" as 
one group! I would recommend that table 3, 4, 5 be emerged into one table and data should be 
presented as "compared with before your operation,............" conclusion: 1. The current results do not support the withdrawn conclusion. As there was no significant difference 
between the two groups regarding Libido and dyparunia. I would strongly recommend presenting the 
data for each response using Odds Ratios and confidence intervals and they should leave it to the reader to decide. 
Abstract 
1 Authors should include the response rate in the result section. The conclusion is not supported by the
results. 
Minor comments: 
1 Please provide the date and duration of the study in the abstract and method sections. 2 Please indicate in table 5 if HRT users are "current users" or "ever users". 3 Tables: please cut the number of table into maximum three. 
4 Discussion: First paragraph could be taken out without significantly affecting the content of the 
discussion. Please cut the discussion. 5 References: please check Reference # 1, #10, #13, #16, #17 for correct authors name1,17, page number10, volume13, journal abbreviations16. 
1. Rhodes et al. Hysterectomy and sexual functioning. JAMA 1999; 282:1934-41 
Competing interests:
None declared.