Only 49% of patients can correctly assess their penile curvature caused by Peyronie’s disease, according to new research published last month in the Journal of Sexual Medicine.
Correct measurements of curvature are important, as they affect both the course and the evaluation of treatment.
Using a goniometer to measure the curve of a medicinally-induced erection at a physician’s office is considered the gold standard method of assessment. However, many clinicians and researchers use measurements that are self-reported by the patient, which are not always reliable.
The study, conducted by scientists at Memorial Sloan-Kettering Cancer Center in New York City, aimed to determine how well a physician’s measurement and a patient’s assessment agreed.
The researchers worked with 192 men with Peyronie’s disease. Their mean age was 54 ± 12 years. The men filled out questionnaires about their experiences with Peyronie’s disease.
Each man was interviewed by a physician. During their discussion, the man was given a goniometer and asked to show the degree to which his penis curved, as he perceived it. The man was fully dressed at this time.
Next, the physician gave the man an intracavernosal injection (ICI) to the penis to induce an erection. Once the erection reached a rigidity equal to or greater than 80%, the physician measured it using the goniometer.
The researchers made room for error, assigning each patient’s estimate to a 10-point range of degrees (0-9 degrees, 10-19 degrees, etc.) The patient’s reading was considered accurate if came within ± 5 degrees of the 10-point range assigned to the physician’s reading. For example, if the patient’s reading fell in the 30-39 degree category, it was deemed accurate if the physician’s reading was in the range of 25 to 44 degrees.
Forty-nine percent of the men assessed their curvature accurately. Curvature was underestimated by 35% of the men and overestimated by 16%.
It’s possible that so many more men underestimated their curvature because erections at home may not have been the “peak” erections that can occur at the physician’s office. More accurate readings were given by men who had stronger erections and less curvature.
The researchers emphasized the importance of standardized evaluation methods, noting that other popular methods, such as at-home photography and vacuum erection devices, were not as reliable as intracavernosal injection.
“Our findings support the view that the objective evaluation of curvature at the time of maximum erection is the most reliable approach. An ‘eyeball’ estimate is no better than a guess. Given that our patients’ guesses yielded lesser magnitudes of curvature than those found with ICI, we recommend that all clinicians utilize only ICI for determining penile curvature,” they wrote.
The Journal of Sexual Medicine
Matsushita, Kazuhito, MD, et al.
“Concordance Between Patient and Physician Assessment of the Magnitude of Peyronie's Disease Curvature”
(Full-text. First published online: October 10, 2013)