3D-Printed Flexible Penile Model Simulator for Plaque Incision and Graft for Peyronie's Disease

Introduction: Plaque incision and graft (PIG) is suggested for the treatment of significant Peyronie's disease (PD), but most surgeons perform very few PIG surgeries annually, and the number of PD cases requiring PIG is inadequate to maintain the necessary skills and completely master the procedure. Aim: To develop and validate a new 3D-printed model of a curved penis and graft to simulate PIG surgery. This is the first PIG surgical training simulator described in the medical literature. Methods: A 3D-printed model of the corpora cavernosa with a 60-degree curvature and an associated urethra was created using a flexible filament of thermoplastic polyurethane. Twenty-two urologists from Brazil were recruited to perform simulated surgery on the 3D model. The participants included 12 senior-level and 10 trainee-level urologists. Main outcome measures: Evaluation of the device was based on a 15-item questionnaire using a 5-point Likert-type scale for each item. Results: Each participant performed one simulated surgery with the 3D-printed model. All participants agreed that the simulation should be implemented into training programs. Participants ranked all content validity components >= 4.41 and all face validity components >= 3.83. The mean usability score was 4.25, and the overall experience scores were 4.75 (senior) and 5.0 (trainee). Conclusion: Senior and trainee urologists evaluated this first reported simulated PIG training model for penile curvature correction as an acceptable tool for training and maintaining necessary PIG skills. This model may improve PIG training and surgeon skill, thereby improving patient safety and outcomes. Copyright (C) 2021, The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.