Reviewer ’s report  
 
Title: Quality of life and the prevalence of urinary incontinence after surgical treatment for  
gynecologic cancer: A questionnaire survey  
 
Version: 1 Date: 21 Jan 2020  
 
Reviewer: Research Square Reviewer 1  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types:  is there a clear objective)?  
Yes - there is a clear objective  
 
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for the 
objective?  
No - there are major issues  
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confidence in the results?  
No - there are minor issues  
 
STATISTICS - Is the use of statistics in the manuscript appropriate?  
Yes - appropriate statistical analyses have been used in the study  
 
INTERPRETATION - Is the current i nterpretation/discussion of the results reasonable and not 
overstated?  
No - there are major issues  
 
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically 
sound? If not, can revisions be made to make the work technically sound?  
Maybe - with major revisions  
 
 
 
PEER REVIEWER COMMENTS:  
 
GENERAL COMMENTS:  
This is a survey based study of urinary issues and quality of life after gynecologic cancer 
surgeries.  This is an important area to study as patients with gynecologic cancers are l iving 
longer with their disease. The study was well conducted and analyzed using validated 
questionnaire based design.  
The authors included patients with various gynecologic cancers who were treated with at least a 
hysterectomy but did not take into accou nt additional surgical procedures that might be disease 
specific as well as the use of subsequent adjuvant therapies (chemo, radiation,etc..) that can be 
expected to have a great impact on bladder function post operatively  
 
REQUESTED REVISIONS:  
-suggest t o  analyze impact of surgery per disease site (ovary, cervix, uterine) as surgical 
treatments and adjuvant therapies can vary widely  
-report demographics of non responders to survey questionaires to see if there exist any bias in 
response  
-comment on the c linical significance of the statistically significance observations in the study  
-comment on the factors included in the logistic model to predict postop urinary incontinence  
-the time between surgery and questionnaire response was quite long. would be bet ter to break 
the analysis down into short term (~12 months) and long term ( &gt;12 months) to see the time 
course of the complication  
 
ADDITIONAL REQUESTS/SUGGESTIONS:  
suggest present the data breakdown with respect to different disease site in table or gra phical 
formats  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your co mments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects requ ire 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:  
 
Acceptable  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain  or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the fut ure? 
 
3. Do you hold or are you currently applying for any patents relating to the content 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.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewers with  
declared or apparent competing interests are not utilized for these reviews. This reviewer has  
agreed to publication of their comments online under a Creative Commons Attribution License  
attributed to Research Square and was paid a small honorarium for completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless o f the reviewer  
recommendation.  
 
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