Introduction: : Among men with Peyronie's disease (PD), the degree of penile curvature has significant implications on psychological well-being, sexual function, treatment planning, and posttherapy evaluations.
Aim: The primary objective of the current study was to correlate patients' estimates of penile angulation with objective measures.
Main outcome measures: (i) Proportion of patients over- or underestimating their actual degree of curvature; and (ii) degree differences between patient estimates and objective measures of penile curvature. Methods. At baseline, patients with established PD were asked to provide a "best estimate" of their degree of penile curvature. Objective measures of penile angulation were then performed using standardized photographs and protractor-based measurement of penile curvature during full erection. Correlations were performed between patient estimates of penile curvature and objective measures of penile angulation.
Results: Eighty-one men with established PD and a mean age of 52 years (range: 20-72 years) were prospectively evaluated. Mean duration of disease was 33 months (range: 6-276 months), and mean plaque size was 1.4 cm +/- 0.1 standardized error (SE). The proportion of patients with dorsal, lateral, and ventral curvatures was 39%, 57%, and 4%, respectively. Patient estimates of baseline penile curvature (mean 51 degrees +/- 3.1 SE) differed significantly from objective measurements (mean 40 degrees +/- 2.4, P = 0.001). A significantly higher proportion of patients overestimate their actual degree of penile curvature (54% overestimate, 26% underestimate, and 20% are accurate within 5 degrees, P = 0.002). Compared with objective measures, patients' estimates of degree of penile curvature differed by an average of 20 degrees +/- 2.2 SE.
Conclusions: Patients with PD tend to overestimate their degree of penile curvature. Objective measurement of penile angulation is necessary to accurately counsel patients regarding disease severity, recommend appropriate treatment strategies, and objectively evaluate outcomes following therapy.