Summary
Introduction
Penile curvature (PC) refers to an abnormal bending of the main longitudinal axis
of the penis. It is frequently associated to hypospadias. To date, accurate and objective
evaluation of PC is not easily reproducible amongst surgeons and there are no stablished
protocols on how to measure PC in a standard way and in real-time to guide intraoperative
decision making. For this reason, we want to present the results of creating a semi-automated
algorithm to establish a reproducible and objective assessment of PC and propose it
as a standard protocol for clinical applicability using inanimate 3-D penile models.
Methods
This project consisted in two different phases. 1. Creation of an automated algorithm
to estimate penile angle based on digital images. 2 Use of the algorithm to estimate
penile angle on 3-D models and estimate interrater agreement using the algorithm.
The algorithm was created to initially identify the geometrical centerline of the
penile model to establish an automated output for angle estimation. 3-D printed penile
models with known curvature angles ranging from 10 to 90° were used to test the algorithm
(total of 9 penile models. These models were curved at one hinge as opposed to an
arc type model. For each inanimate model, a set of 5 pictures were obtained from a
lateral view at different camera angles (00, 150, 300, 450 and 600) at a standard distance of 75 cm. Angle estimation using our designed PC algorithm
was performed by a total of 10 different evaluators. Inter-rater reliability analysis
in using the semiautomated algorithm was performed using the inter-class correlation
coefficient (ICC) with two-way mixed effect model.
Results
If the camera angle was greater than 30°, the absolute angle mean difference was greater
than 10°. Camera angle with the smallest mean difference was at 00 with a mean difference of 7.83°. Agreement between raters showed greater variability
towards the higher camera angles. Nonetheless, a high degree of between evaluator
reliability was found between the measurements at different camera angles. Single
measures ICC ranges from .873 to .946, p-values were all <.0001.
Conclusion
Graphical AbstractSemi-automated digital output for angle estimation at 20 degree camera angle.
Keywords
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Article info
Publication history
Published online: January 12, 2021
Accepted:
January 7,
2021
Received in revised form:
December 28,
2020
Received:
November 18,
2020
Identification
Copyright
© 2021 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
