Patient comfort by design: Mobile diagnostics for Peyronie’s disease

Sexual health can be an uncomfortable topic of conversation for patients, some of whom may prefer more discrete options for sharing intimate details. In a first-of-its-kind study, Vancouver Coastal Health Research Institute (VCHRI) researchers have demonstrated the viability of the PenoMeter novel mobile option for diagnosing Peyronie’s disease. 

Peyronie’s disease is characterised by penile curvature, pain and shortening during an erection due to an overgrowth of fibrous scar tissue in the lining of the erection chambers within the penis. Under current Canadian Urology Guidelines, the presence of the condition is assessed by a physician in-office either by inducing an erection or having a patient share images of their erection, with the present accuracy of the latter being low.

“Assessing Peyronie’s disease can be a fairly uncomfortable and time-consuming experience for patients,” shares VCHRI researcher and study co-author, Dr. Ryan Flannigan. “For an in-clinic assessment of an erection, a physician will administer an injectable medication to trigger it, measuring its curvature and rigidity. Sometimes, additional injections of medications are needed to resolve erection. In total, this process usually takes between 60 and 90 minutes.”

“The PenoMeter shows promise as a means to further standardise and streamline Peyronie’s disease diagnostic assessments.”

Developed by VCHRI researcher Dr. Faraz Hach, Flannigan and collaborators, the PenoMeter is a web-based program that uses artificial intelligence (AI) to support the accurate assessment of Peyronie’s disease. The algorithm was first trained on a series of images of Peyronie’s disease and healthy controls to differentiate between disease and normal characteristics. 

Using a built-in reference of disease characteristics, the PenoMeter’s algorithm was fed 66 images of the erections of 22 study participants with Peyronie’s disease. Along with identifying the telltale signs of the disease, the AI algorithm also masked participants’ erections. “This added layer of anonymity can give patients greater peace of mind,” explains Hach. 

This first iteration of the PenoMeter tested in Flannigan and Hach’s study predicted the curvature abnormalities associated with Peyronie’s disease with an accuracy of 86 per cent, comparable to the performance of three sub-specialist urologists who reviewed the same images. While differences in specialist assessments of penile curvature varied between 3.8 and 7.8 degrees, the PenoMeter’s measurements were highly consistent, representing zero degrees of difference between measurements over time.

“The PenoMeter’s built-in standardised set of parameters to characterise Peyronie’s disease can significantly reduce clinician biases and subjectivity in the assessment process, streamlining and advancing diagnostic standardisation for Peyronie’s disease,” says Flannigan.

Advanced technology offers greater accuracy and patient peace of mind

Peyronie’s disease is a benign yet psychologically and psychosocially burdensome condition affecting mostly males ages 45 to 60 years. Approximately nine per cent of Canadian males — over 1.8 million people — live with the condition. Of these, around 50 per cent will experience depression, with many individuals suffering in silence, shares Flannigan. 

An added benefit of the PenoMeter is its potential to offset costs and free up clinical time for patient care. Although some clinical assessments to confirm the condition are covered by British Columbia’s Medical Services Plan, others are not — such as medication needed during the assessment, which can range anywhere from $200 to $300.

A subsequent iteration of the PenoMeter will likely integrate a mobile application that can establish a standardised way for patients to photograph their erections. 

“This could look like floating crosshairs in a photo application on a mobile device within which to align the erection, and could incorporate functionality, such as offering clinicians the ability to rotate the three-dimensional renderings,” shares Hach. “Technologies like this can improve the consistency of the angles of the images uploaded to the PenoMeter, which will translate into more accurate assessments for clinicians to review when making treatment recommendations.”  

“We are already in the midst of developing the next iteration of the PenoMeter, with plans underway to collaborate with other centres in the pursuit of additional clinical trials,” says Hach.