Subjective
Date of visit
Reason for visit (initial presentation, follow-up)
History of present illness:
Onset and duration of penile curvature during erection
Severity of curvature (degree of bend)
Pain during erection or intercourse (location, character)
Difficulty achieving or maintaining an erection (erectile dysfunction)
History of trauma to the penis (if applicable)
Past medical history (relevant conditions like diabetes)
Medications (current medications)
Allergies
Objective
Vital signs (temperature, heart rate, blood pressure)
Physical exam:
General inspection of the penis:
Presence of palpable plaque(s) under the skin of the penis (dorsum, tunica albuginea)
Degree and direction of penile curvature during erection (if possible)
Assessment of erectile function (if indicated):
Palpation of corpora cavernosa for fibrosis or induration
Assessment
Peyronie’s disease (suspected based on clinical presentation)
Severity of curvature (mild, moderate, severe)
Impact on sexual function (erectile dysfunction)
Consider differential diagnoses (fibrosis due to other causes, congenital penile curvature)
Plan
Depending on the severity, stage of disease (acute vs. chronic), and patient’s goals, consider:
Observation (for mild curvature and minimal symptoms)
Oral medications (vitamin E, carnitine) – limited evidence for efficacy
Injection therapy with medications like verapamil or interferon (to soften plaques)
Traction therapy (devices to stretch the penis and improve curvature)
Surgical intervention (plaque excision and grafting for severe curvature or erectile dysfunction) – usually a last resort
Pain management medications (may be prescribed for pain during intercourse)
Education
Explain the diagnosis, stages of Peyronie’s disease, and treatment options
Discuss realistic expectations for improvement
Importance of addressing any psychological concerns related to sexual function
Follow-up
Schedule for next appointment:
Monitor response to treatment (improvement of curvature, pain)
Consider referral to a urologist for further evaluation or specialized treatment (if needed)
Note: This template is a guide and may need to be modified based on the individual patient’s presentation, severity of Peyronie’s disease, and impact on sexual function.
Disclaimer: This information is for educational purposes only and should not be interpreted as medical advice. Please consult with a qualified healthcare professional for diagnosis and treatment of Peyronie’s disease.