Urological Manifestations of the Systemic Vasculitides—A Scoping Review

Round 1

Reviewer 1 Report

Dear Authors

First, I would like to congratulate you on submitting a detailed manuscript. The work has merit and will be of interest to our readers. However, it needs significant revisions. My comments are as follows:

• From the work, it appears you have performed a 'scoping review'. It will be better to change the title to 'Urological manifestations of the systemic vasculitides- a scoping review'.
• Providing a simple workflow/search process flow (like PRISMA) adds to the value of the manuscript. Please mention a search workflow. You have mentioned your inclusion and exclusion criteria- just present them in a flow diagram.
• Table 1 as such is of little importance. It will be better if you can add two columns. One column, of the main organ systems involved. The second column, of the vessels from the urinary system (e.g. renal, testicular, epididymal, etc.) which are commonly involved in each vasculitis.
• The section on the diagnostic approach to systemic vasculitides can be removed and replaced by a table. It is redundant and making the manuscript very lengthy.
• The manuscript is very detailed. A review article doesn't mean you have to explain everything. Many sections are redundant and can be shortened:

a) In each section, few case reports have been mentioned. Please shorten these case scenarios. Unnecessary details can be removed.

b) Please restrict yourself to urological manifestations only. There are a number of sections where other manifestations are elaborated. This can be easily omitted.

c) Table 2, 3, 4 are redundant. The information in these tables can be briefly (only mention the organ system) highlighted in a column of table 1 (as mentioned above).

d) Similarly, the sections on EGPA (very long description of case reports), IgAV (both presentation and treatment parts), BD are very long. All these need to be shortened.

• Lastly, my advice to the authors is to make a summary figure/table. They can depict the type of vasculitis involving the specific part of the urinary system. For e.g., a cartoon of the urogenital system can be made depicting kidneys, ureters, bladder, urethra, testis. Then you can mention which type of vasculitis involves which part of the urogenital system. This will provide a brief overview to the readers and will improve the quality of the manuscript.

 

Author Response

In reference to the decision of major revisions for the uro-1416737 manuscript, we are submitting a revised version of the article. All issues  have been meticulously corrected. A detailed report on the amendments is presented below. If the Reviewer request additional language corrections, we will immediately send our manuscript to MDPI English Editing Service. Additionally, we decided to perform literature search once again as the last search was conducted almost one year ago (please see Evidence acquisition section).

 

1. It will be better to change the title to 'Urological manifestations of the systemic vasculitides- a scoping review'.

Our response: We changed the title as suggested (see line 1-2). 

2. Providing a simple workflow/search process flow (like PRISMA) adds to the value of the manuscript. Please mention a search workflow.

Our response: The flowchart of the study selection process was added (see Figure 2).

3. Table 1 as such is of little importance. It will be better if you can add two columns. One column, of the main organ systems involved. The second column, of the vessels from the urinary system (e.g. renal, testicular, epididymal, etc.) which are commonly involved in each vasculitis.

Our response: The contents of the Table 1 were modified (see Table 1).

4. The section on the diagnostic approach to systemic vasculitides can be removed and replaced by a table. It is redundant and making the manuscript very lengthy.

Our response: The section regarding diagnostic approach was removed and replaced by a figure (see Figure 1)

5. In each section, few case reports have been mentioned. Please shorten these case scenarios. Unnecessary details can be removed.

Our response: Case scenarios were shortened as suggested.

6. Please restrict yourself to urological manifestations only. There are a number of sections where other manifestations are elaborated. This can be easily omitted.

Our response: We removed paragraphs including description of non-urological manifestations of vasculitides.

7. Table 2, 3, 4 are redundant. The information in these tables can be briefly (only mention the organ system) highlighted in a column of table 1 (as mentioned above).

Our response: Data from table 2,3,4 were presented in table 1 (see Table 1).

8. Similarly, the sections on EGPA (very long description of case reports), IgAV (both presentation and treatment parts), BD are very long. All these need to be shortened.

Our response: Above mentioned sections were shortened as suggested.

9. Lastly, my advice to the authors is to make a summary figure/table. They can depict the type of vasculitis involving the specific part of the urinary system.

Our response: We provided additional summary figure as suggested (see Figure 3).

 

 

Reviewer 2 Report

1416737: Review Report

 

Comments to the Authors,

 

This manuscript aimed to review the clinical characteristics and manifestation of systemic vasculitides. This manuscript is repetitive of an existing publication entitled “Urological manifestations and treatment of the primary systemic vasculitides” (World J Clin Urol. Mar 24, 2015). The current version of this manuscript does not provide additional insights and or a new clinical/research perspective to be published in addition to the existing publication. 

 

The following shows my suggestions and comments. A major concern comes along with #1 which comes from my review above. All other suggestions and comments are minor.

 

1. An existing publication entitled “Urological manifestations and treatment of the primary systemic vasculitides” (World J Clin Urol. Mar 24, 2015) needs to be cited. Then, authors should add additional insights and a new clinical/research perspective which distinguishes the manuscript from the existing manuscript in a significant way. The written contents which are added in response to the review needs to be highlighted in the manuscript so that the readers can recognize the emphasis of this manuscript.
   
   
2. References need to be added at the end of the sentences written in the following lines.
   Line 40 – urogenital manifestations of primary systemic vasculitides.
   
   
3. A brief summary and references of the existing literature that discusses the urological aspects of vasculitides at the end of the paragraph written in line 40~48.
   
   
4. The purpose of section 3. The diagnostic approach to systemic vasculitides is not clear and needs to be added. In the way that it is written, this section does not fit well with the main topic and title of this manuscript. Here is an example of how to provide your purpose in section 3.
   
   Current version: It is not possible to outline a single algorithm for evaluating patients suspective of having any one of the vasculitides due to the clinical heterogeneity of these disease. In general, the presence of vasculitis should be considered in patients who present with systemic or constitutional symptoms in combination with evidence of single and/or multiorgan dysfunction and especially with some key manifestations.
   
   Suggestions: It is not possible to outline a single algorithm for evaluating patients suspective of having any one of the vasculitides due to the clinical heterogeneity of these disease. Therefore, this review provides an overview about the diagnostic approach to systemic vasculitides instead of reviewing its aspect in urological manifestation in a specific manner in this section. In general, the presence of vasculitis should be considered in patients who present with systemic or constitutional symptoms in combination with evidence of single and/or multiorgan dysfunction and especially with some key manifestations.

Author Response

In reference to the decision of major revisions for the uro-1416737 manuscript, we are submitting a revised version of the article. A detailed report on the amendments is presented below. If the Reviewer request additional language corrections, we will immediately send our manuscript to MDPI English Editing Service. Additionally, we decided to perform literature search once again as the last search was conducted almost one year ago (please see Evidence acquisition section).

1. An existing publication entitled “Urological manifestations and treatment of the primary systemic vasculitides” (World J Clin Urol. Mar 24, 2015) needs to be cited. Then, authors should add additional insights and a new clinical/research perspective which distinguishes the manuscript from the existing manuscript in a significant way. The written contents which are added in response to the review needs to be highlighted in the manuscript so that the readers can recognize the emphasis of this manuscript.

Our response: In the introduction section we highlighted that above mentioned manuscript was previously published (in 2015). We found it reasonable to perform new review regarding the urological manifestations of primary systemic vasculitides because several new studies and cases have been published since Peracha et al. work.

2. References need to be added at the end of the sentences written in the following lines. Line 40 – urogenital manifestations of primary systemic vasculitides.

Our response: We changed the structure of this paragraph and deleted above mentioned sentence.

3. A brief summary and references of the existing literature that discusses the urological aspects of vasculitides at the end of the paragraph written in line 40~48.

Our response: Please see comment above.

4. The purpose of section 3. The diagnostic approach to systemic vasculitides is not clear and needs to be added. In the way that it is written, this section does not fit well with the main topic and title of this manuscript. Here is an example of how to provide your purpose in section 3.

Our response: The section regarding diagnostic approach was removed and replaced by a figure (see Figure 1) because detailed review of diagnostic pathways exceeded the scope of our review.

Round 2

Reviewer 1 Report

I would like to congratulate the authors for their work. The authors have incorporated all my suggestions. The overall scientific quality of the manuscript has improved significantly. Only a spell check is required to correct the minor grammatical errors. 

Reviewer 2 Report

This manuscript is recommended for publication in Uro in present form.