(PM-30) Comparison of non-invasive measurements for penile curvature estimation in Peyronie’s disease

Abstract Objective This study evaluated the accuracy of different techniques for non-invasive curvature estimates and compared to gold standard. Materials and Methods We retrospectively reviewed records of patients undergoing surgery for PD at a tertiary center. Preoperative non-invasive assessments of curvature included patient-indicated curvature using a goniometer, drawing of the penis, modeling with a malleable prosthesis, and at-home photography with maximal erection. Intra-operative curvature was measured using a goniometer after saline-induced rigid erection. A difference < 10° or < 20% compared to intraoperative measurement was considered tolerable; deviations beyond this were categorized and reported as either over or underestimations. Results Sixty-nine men (mean age 62 ± 6 years) were included. Overestimation, underestimation, and precision rates were 33%, 22%, and 44% for goniometer; 37.5%, 12.5%, and 50% for prosthesis; 30%, 22%, and 48% for photography; and 41%, 12%, and 47% for drawing. Drawing (MD 10.24°, 95% CI: 1.18– 19.29; p = 0.0232) and prosthesis (MD 9.53°, 95% CI: 1.76– 17.29; p = 0.0123) showed a tendency of overestimation. Photography (MD 4.96°, 95% CI: –2.50– 12.43; p = 0.2751) and goniometer (MD 6.24°, 95% CI: –1.74– 14.22; p = 0.1629) did not significantly differ from surgical measurements. The heatmap analysis, comprising 34 complete records, revealed considerable variability across non-invasive measurement methods when compared to the intra-operative surgical reference. The analysis demonstrated a statistically significant effect of the measurement method on the recorded values (F (3.609, 172.3) = 2.825; p = 0.0311). Conclusions Overall, non-invasive methods demonstrated limited precision, reinforcing the need for objective evaluation, such as with intracavernous injection, to guide management in PD. Financing No conflict.