Single-Stage Trans-Vestibular and Foley’s-Assisted Epispadias Repair (STAFER) for Girls with Incontinent Epispadias: A Retrospective Study from a Tertiary-Care Center

Round 1

Reviewer 1 Report

The problem of female epispadias is a very rare disease, therefore collecting medical data is extremely difficult. One-step surgical treatment  is also a challenge. Therefore, I consider this research work very valuable.

1. I recommend re-examining the description of the surgical technique to make it clearer for the reader.
2. Figure 1B, 1C, and 2B were not visible to the reviewer and therefore difficult to evaluate

Author Response

The problem of female epispadias is a very rare disease, therefore collecting medical data is extremely difficult. One-step surgical treatment is also a challenge. Therefore, I consider this research work very valuable.

1. I recommend re-examining the description of the surgical technique to make it clearer for the reader.

Reply: Many thanks for highlighting this issue. In the revised manuscript, the description of the technique has been made clearer.

2. Figure 1B, 1C, and 2B were not visible to the reviewer and therefore difficult to evaluate

Reply:  Thanks for the comment. We have provided all the figures in the manuscript.

Reviewer 2 Report

this is case series study and it should be presented according to CARE statement (CARE Case Report Guidelines (care-statement.org)

Author Response

This is case series study and it should be presented according to CARE statement (CARE Case Report Guidelines (care-statement.org)

Reply:  Many thanks for the comment by the esteemed reviewer. The present manuscript depicts a single-center, single-surgeon experience of the management of female epispadias. The submission also highlights the important aspects of our surgical technique. The less number of cases (n=9) in the present study is because of the extreme rare incidence of the anomaly (1:4,50,000). Recently published original articles (reference no 7 and 8) also have six and ten cases respectively. Therefore, it should not be considered as a case–series.

Reviewer 3 Report

I congratulate you for coming up with this article. Level of Originality, Writing Style and Clarity is good in this article.  The subject of the work is of interest. However, there are some points that need consideration:

• The manuscript needs proof reading by a native speaking expert.
• If this study is retrospective study, please include the information of `Retrospective study` in the title.
• The Keywords should be checked in Mesh database.
• The keywords should be sorted alphabetically.
• Does INTRODUCTION include: “What we know”, “What we don’t know” and “Aims”?. Authors did not comment on the gap of knowledge the current research will try to fill. Authors did not report related researches and what they were missing.
• Statistical method is lacking in methods section.
• Report the ethical code.
• Rest of manuscript: : no modification needed.

Author Response

I congratulate you for coming up with this article. Level of Originality, Writing Style and Clarity is good in this article.  The subject of the work is of interest. However, there are some points that need consideration:

1. The manuscript needs proof reading by a native speaking expert.

Reply: Thanks for the useful comment. The manuscript has been screened using premium version of a writing assistant (Grammarly software) and necessary corrections have been done.

2. If this study is retrospective study, please include the information of `Retrospective study` in the title.

Reply: Many thanks for highlighting this issue. We have added this in the title of the study.

3. The Keywords should be checked in Mesh database. The keywords should be sorted alphabetically.

Reply: Thanks for the useful comment. The necessary corrections have been made.

4. Does INTRODUCTION include: “What we know”, “What we don’t know” and “Aims”?. Authors did not comment on the gap of knowledge the current research will try to fill. Authors did not report related researches and what they were missing.

Reply: Many thanks for the expert comments. The Introduction section very clearly depicts “What we know” about this extremely rare anomaly. What we don’t know, the current gaps in knowledge, aims have been highlighted in the revised manuscript.

5. Statistical method is lacking in methods section.

Reply: Thanks for highlighting this issue. In the revised manuscript, we added a paragraph on statistical analysis (highlighted).

6. Report the ethical code.

Reply: Many thanks for highlighting this issue. In view of the retrospective nature of the study, the ethical waiver was obtained by the Institutional review board.

7. Rest of manuscript: no modification needed.

Many thanks for spending your valuable time in reviewing our manuscript.