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Peyronie’s Plaque and Penile Curvature

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Self-Assessment Questionnaire

This questionnaire serves as a guide to assess symptoms related to Peyronie’s plaque and
penile curvature. It aims to help individuals determine the severity of their condition and
decide when to seek medical evaluation. Always consult a healthcare professional for
accurate diagnosis and personalized treatment options.

Peyronie's Plaque and Penile Curvature

Peyronie's Plaque and Penile Curvature

1. Please indicate the direction and severity of your penile curvature
2. Peyronie's Plaque - Check if you have experienced any of the following symptoms
3. How do these symptoms affect your sexual function and intimacy?
5. How long have you been experiencing these symptoms?
6. How often do you notice these symptoms?

Scoring Instructions:

Add up the points based on your responses:

  • Severity of penile curvature (0-10 scale): ______
  • Concern or distress level (0-10 scale): ______

What is your score?

  • 0-5 points: Monitor symptoms; periodic assessment recommended.
  •  6-10 points: Consider consulting a healthcare provider specializing in urology.
  • 11 or more points: Immediate consultation advised; symptoms may require medical intervention.

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