PD48-02 HIGH INTEROBSERVER VARIABILITY OF PENILE CURVATURE MEASUREMENTS BY GONIOMETER IN PEYRONIE’S DISEASE

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Peyronie's Disease (PD48)1 Sep 2021PD48-02 HIGH INTEROBSERVER VARIABILITY OF PENILE CURVATURE MEASUREMENTS BY GONIOMETER IN PEYRONIE’S DISEASE Elizabeth Nagoda, Adam Nolte, Anthony Bui, Chase Mallory, George Wayne, and Alan Polackwich Elizabeth NagodaElizabeth Nagoda More articles by this author , Adam NolteAdam Nolte More articles by this author , Anthony BuiAnthony Bui More articles by this author , Chase MalloryChase Mallory More articles by this author , George WayneGeorge Wayne More articles by this author , and Alan PolackwichAlan Polackwich More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002070.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Peyronie’s Disease (PD) refers to curvature of the erect penis caused by fibrosis of the tunica albuginea of the corpora cavernosa. In 2013, collagenase clostridium histolyticum was approved for curvature greater than 30 degrees following two large double blinded placebo-controlled trials. In these trials, curvature improved by 17.0 ± 14.8 degrees by goniometer measurement. Despite being the gold standard, goniometer measurements have not been validated on the same penile model across multiple observers. We aimed to investigate this unstudied measurement bias using 3D printed models of PD. METHODS: We created three penile models using computer modeling and 3D printing. Measurements were made by attending urologists and urology residents at our institution. Measurements were obtained by phone (P), exam (E), and goniometer (G). Measurements were compared to a high-volume PD urologist using the one-sample t-test. Variability between the measurements obtained by different methods were assessed using intra-class correlation coefficient (ICC). The PD models are shown in figure 1. RESULTS: For each model, a high-volume PD urologist was tasked to measure the models. Model 1 was measured at 35°left and 50°dorsal (P), 45°and 70°(E), and 45°and 57°(G). Participants measured model 1 at 38°±16°and 39°±15°(p=0.25) (P), 38.9°±20°and 41.8°±15°(E), and 35 ± 9°and 45 ± 8°(G) (p <0.01). The second model was measured at 45°(P), 45°(E), and 50°(G) left curve. Participant measurement was 36°±12°(P), 36°±12°(E), and 40.7 ± 8°(G) (p <0.001). The third model measured as a 60°(P), 60°(E), and 60°(G) ventral curve. The participants measured at 48°±16°(P), 47°±15°(E), and 50°± 8°(G) (p <0.01). ICC was 0.54 for phone, 0.6 for exam, and 0.27 for goniometer. Poorest measurement agreement was seen using goniometer. CONCLUSIONS: Accurate measurements of PD are essential, as they are used to determine surgical technique and gain approval for intralesional injections. Here we present the first study assessing the variability of phone, exam, and goniometer measurements among urologists. We demonstrated that measurement agreement is poor which has implications on PD treatment decisions and PD research. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e838-e839 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Elizabeth Nagoda More articles by this author Adam Nolte More articles by this author Anthony Bui More articles by this author Chase Mallory More articles by this author George Wayne More articles by this author Alan Polackwich More articles by this author Expand All Advertisement Loading ...