MP47-10 PEDIATRIC UROLOGISTS' ASSESSMENT AND MANAGEMENT OF PEDIATRIC PENILE CURVATURE

Abstract

You have accessJournal of UrologyPediatric Urology III (MP47)1 Sep 2021MP47-10 PEDIATRIC UROLOGISTS' ASSESSMENT AND MANAGEMENT OF PEDIATRIC PENILE CURVATURE Mei Tuong, Anthony Herndon, Carlos Villanueva, Patricio Gargollo, Andrew Winkelman, and Nora Kern Mei TuongMei Tuong More articles by this author , Anthony Herndon Anthony Herndon More articles by this author , Carlos VillanuevaCarlos Villanueva More articles by this author , Patricio GargolloPatricio Gargollo More articles by this author , Andrew WinkelmanAndrew Winkelman More articles by this author , and Nora KernNora Kern More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002068.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Method for correction of pediatric penile curvature (PC) usually is dependent on degree of PC which is reliant on how degree is assessed. We sought to assess the confidence and accuracy of measuring PC and hence management using case-based examples. METHODS: An email survey was sent to 355 active members of the Societies of Pediatric Urology. The survey consisted of case scenarios and assessed the management technique and confidence in ability to measure PC. RESULTS: The response rate was 30% (108/355); 97% were fellowship trained. 75% worked in an academic institution, and 50% had greater than 20 years of experience. A Likert scale from 1-5 measured provider confidence on estimating PC; the mean confidence score was 3.6±0.8 (3-fairly confident; 4-very confident). In clinic, 89% of providers used eyeball estimates to assess PC; 5% used both eyeball and goniometer. In the operating room, 71% used eyeball estimates, 8% used goniometer, and 16% used both. If sole decision-maker, providers recommend surgical correction of PC over observation at median 30° (IQR 21-30°). At a median of 45°, there was a shift in corrective surgical preference from dorsal plication (DP) (IQR 30-54°) to ventral lengthening (VL) (IQR 34-60°). See Table 1. Providers underestimated PC degree for all cases. In case 1, only 24% of providers would correct a mean estimate of 23° PC; those who would correct had a higher mean PC estimate vs those who would not (28° vs 21°, p<0.001). Case 2 and 4 had similar estimations and correction methods. In case 2, those who chose VL had a higher mean PC estimate vs those who did not (43° vs 37°, p<0.01), but no estimate difference was seen for DP (p=0.52). In case 4 with lateral PC, those who chose DP had a higher mean PC estimate vs those who did not (41° vs 33°, p=0.049). Yet in case 3, there was no difference in PC estimate in providers who chose VL vs not (57° vs 53°, p=0.16). For all cases, there was no association between provider years in practice or confidence level on estimated PC degree. CONCLUSIONS: A uniform underestimation of PC exists despite provider reported confidence in the ability to measure PC. An increasing willingness to perform surgical correction was demonstrated with a shift towards VL for ventral curvature and less so for lateral curvature as PC worsens. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e826-e827 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mei Tuong More articles by this author Anthony Herndon More articles by this author Carlos Villanueva More articles by this author Patricio Gargollo More articles by this author Andrew Winkelman More articles by this author Nora Kern More articles by this author Expand All Advertisement Loading ...