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S14-5
(PP)
USE OF A NOVEL DIGITAL PHOTOGRAPHY BASED SMARTPHONE APP
(MEDMEASURE!) TO MAKE PENILE LENGTH MEASUREMENTS BOTH DURING AND
AFTER PENILE RECONTRUCTION SURGERY: A VALIDATION STUDY
Anne-Francoise SPINOIT
1
, Charles VAN PRAET
1
, Luitzen-Albert GROEN
1
, Erik VAN LAECKE
1
, Piet HOEBEKE
1
, John
BOSCARDIN
2
and Maurice M. GARCIA
3
1) UNIVERSITY HOSPITAL GHENT, Urology, Ghent, BELGIUM - 2) University of California San Francisco, Department of
Biostatistics and Epidemiology, San Francisco, USA - 3) University of California San Francisco, Urology, San Francisco,
USA
PURPOSE
Stretched penile length (SPL) is the standard measurement used in reconstructive penile surgery (RPS), but is
associated with high inter-rater variability, and is seldom reported. Furthermore, ruler-based measurements require all
measurements to be made intraoperatively ; post-hoc measurements are difficult to impossible. We used a novel
smartphone application to assess the correlation of post-op digital photography (DP) based length measurements to
intraoperative ruler measurements (IORM).
MATERIAL AND METHODS
Intraoperative SPL (SPL-IO) was measured in a consecutive series of patients undergoing RPS. A DP was taken as proof
with the ruler from a true lateral view. A second DP was taken at the same time, with a reference object (OBJ) (object
whose dimensions are known and constant). SPL was measured post-operatively using theMedMeasure!App for iPhone
and iOS Android, using the DP with OBJ, by two different surgeons blinded to SPL-IO. The three different measurements
(SPL-IO, and post-op using the App (SPL-S1 – SPL-S2)) were compared to assess overall correlation and correlation to
ruler measurements using SPSS 20.0 .
RESULTS
20 consecutive patients underwent surgery for hypospadias (n=15), buried penis (n=1), epispadias (n=3) and
circumcision accident (n=1). Median age at surgery was 18 months [6-301]. Median penile SPL-IO was 3.8 cm [2.4 -
8.9]. When SPL-IO, SPL-S1 and SPL-S2 were treated as independent measurements, there was no statistical difference
between any of the three groups (p 0.51-0.81). Even with SPL-IO measurements treated as the gold standard, by
Bland-Altman Limits of Agreement analysis, the correlation factor of SPL-IO to SPL-S1 & SPL-S2 was >99%.
CONCLUSIONS
When compared with IORM, digital measurements using MedMeasure! are reliable and precise. Because measurements
are made based on DP limitless length measurements can be made post-hoc. Use of DP and this smartphone App has
the potential to aid in surgical planning, improve documentation, and facilitate clinical research.