Presentation Authors: Deji Akiboye*, London, United Kingdom, Pareeta Patel, Angus Campbell, Professor Nick Watkin, Surrey, United Kingdom
Introduction: Subjective measures of successful penile curvature surgery are poorly defined. This study follows the 6 year development of a PROM for patients with stable Peyronie's disease (PD) undergoing corrective surgery in a single centre, measuring pre and post operative outcomes prospectively.
Methods: Semi-structured interviews with PD patients identified four domains for assessment - penile appearance (PA), erectile function (EF), sexual relationships and generic quality of life (GQoL). A RAND consensus group of UK andrologists defined the initial item-specific PROM 1. Questions about PA were created de-novo. EF and QoL questions were modified for PD based on IIEF and EQ5-D questionnaires respectively. PROM 1 was piloted on all patients being considered for PD surgery at a single centre over a 3 year period. A test-retest design was used for pre operative assessment, with further post operative assessment at follow up. Following statistical assessment for validity, and modification based on patient feedback, a second iteration PROM 2 was created and tested over a further 3 year period. Wilcoxon Signed Rank test was used to assess consistency between test/retest scores, and significant differences between pre and post operative scores.
Results: The baseline PROM 2 was completed at first assessment by 58 men who all underwent surgery. Retest questionnaires were completed on the day of surgery with post operative questionnaires completed at first follow up. All questions had response rates >85%. Median age was 56 years (26-70 years), median time between test and retest PROMs was 169 days (13-492 days) with median time to follow up 110 days (61-299 days)._x000D_
Wilcoxon Signed Rank test indicated no significant difference between pre-operative test and retest scores for PA, erectile function, relationship or GQoL (P>0.101). However, pain scores significantly reduced between test and retest assessment (P = 0.05). _x000D_
No significant difference was seen between pre and post operative EF, use of PDE5 inhibitors, penile pain, relationship or GQoL scores. Sexual relationships (P = 0.049) and PA showed significant improvement between pre and post operative scores over all questions (P < 0.001).
Conclusions: ED, use of PDE5 inhibitors and QoL are not affected by penile curvature surgery. Subjective penile appearance and sexual relationships improve significantly post operatively. There was a significant reduction in pain sensation pre-operatively and surgery did not adversely affect pain afterwards. The final iteration, PROM 3 is now suitable for internal use and external validation.