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.
Filho et al. (2026) studied this question.