LENGTHENING PROCEDURES IN PEYRONIE'S DISEASE: ASSESSMENT OF SURGICAL VIDEOS ON YOUTUBE IN TERMS OF EDUCATIONAL CONTENT

Abstract

Objectives: In patients with complex and severe penile curvature due to Peyronie’s disease, the standard recommended method is plaque incision/excision + grafting (PIG/PEG) also known as lengthening procedures. In this study, we aimed to evaluate the lengthening procedures for Peyronie’s disease on YouTube in terms of educational content.

Methods: A comprehensive search was carried out using the keywords “Peyronie’s disease surgery, penile curvature surgery, plaque incision/excision, and grafting” on YouTube. Only videos of PIG and PEG methods were included in the study. Videos for penile implantation, penile plication, and extratunical grafting methods were excluded. The remaining videos were evaluated by 3 urology specialists using an assessment tool developed for this study. The tool comprised three parts: preoperative evaluation, intraoperative steps, and audiovisual evaluation, totaling 18 items. Each item was scored from 0 to 2 as “not presented”, “partially presented” and “completely presented”, respectively. The intraclass correlation coefficient (ICC) was used for interrater reliability analyses.

Results: A total of 30 videos were analyzed. The median video length was 457 seconds (IQR = 223-579). Based on the ICC analysis, the agreement between raters was either good or excellent (ICC> 0.75) for all items. Surgical characteristics are summarized in Table 1. Table 2 represents the video assessment and mean scores of each item. In the preoperative evaluation, only deformity characteristics were well demonstrated, while patient characteristics, information on penile length, and erectile status were insufficient. Intraoperative steps were generally well demonstrated, and the best stages were the plaque incision/excision, and deformity control with erection testing. On the other hand, suture materials and the closure and dressing stages of the surgery were generally neglected. The audiovisual evaluation showed that while the resolution and angle of the videos were generally good, the language used in the videos was often inadequate.

Conclusions: Intraoperative steps are mostly well covered in PIG/PEG surgery videos on YouTube. The addition of preoperative evaluation and the use of appropriate, understandable language in the videos will increase the educational nature of the videos.