Introduction

Curvature assessment (CA) in Peyronie's disease (PD) is a critical step in the evaluation of the PD patient. Assessment using combined intracavernosal injection and goniometry (IG) is the standard approach. _x000D_ Aim: to evaluate the utility of novel software (GoSoft) for the measurement of the PD deformity.

Methods

Population: men with PD, who had a CA using IG. A rigid erection was an inclusion criterion for inclusion in this analysis. Degree of curvature was measured with a goniometer, simultaneously a photograph was taken. The photo was analyzed using GoSoft software by three observers at different time points, each being blinded to the goniometer assessment. The primary outcome was to compare the inter-observer and intra-observer reliability of GoSoft. We also aimed to compare the concordance between GoSoft and goniometry. We compare correlation for curvature ≤ 45 degrees and for > 45 degrees. We accepted a variability of 5 degrees and considered an under and over-estimation if the difference was >5 degrees.

Results

53 subjects were included. The intra-observer reliability was excellent, representing a high correlation ( r=0.96 to 0.98, p<0.001) with a variance between means of 1.3±0.6 degrees. The inter-observer reliability was also high (r=0.89 to 0.95, p<0.001) (Figure 1) with a variance between means of 2.2±1 degrees. The Pearson correlation coefficients (r) between the goniometer and GoSoft for each rater were: Rater 1: r=0.75, p<0.001; Rater 2: r=0.73, p<0.001; and Rater 3: r=0.80, p<0.001. This indicates strong agreement, but also suggests variability between the types of measurement. For the three raters, when comparing GoSoft to the goniometer, GoSoft accurately measured (within ±5 degrees) 45% of the curvatures, underestimated it by >5 degrees in 25% of the curvatures, and overestimated it by >5 degrees in 30% of the curvatures. The correlation appears to be higher for greater curvatures. For curvature ≤ 45 degrees, the correlations between goniometer and GoSoft ranged from: r=0.41-0.47, p=0.03; while, for curvatures > 45 degrees, the correlations ranged from: r=0.59-0.65, p<0.01.

Conclusions

GoSoft assessment is consistent with goniometry. The excellent reliability and reproducibility might provide a more standardized instrument for CA in men with PD.

Funding

none