Maladie de Lapeyronie
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Peyronie's Disease - Patient file

Auteur : Docteur Marc Galiano - Date de dernière mise à jour : 3 September 2015

Peyronie’s disease patient file: to be put together before your consultation


You have diagnosed Peyronie’s disease or you think you may have Peyronie’s disease and wish to see Doctor Marc Galiano.

Doctor Galiano will need the following items during your first consultation:

The 3 questionnaires (EHS, IIEF5 and pain according to T.LUE) (download and print here)

3 photos of your erect penis (on plain background, taken at a distance of 50 cm/1 m)

  1. 1 photo STRICT right or left profile (or both)
  2. 1 top view photo
  3. 1 front view photo

You should bring the questionnaires and photos with you on your on your first visit to the doctor’s surgery or send them by email to before your appointment.

Treatment can only begin once Doctor Marc Galiano has all these items, which are necessary for diagnosis and monitoring the treatment. Filling them in beforehand at home not only allows you to take your time to think and best answer the questions, but it will also save time since the diagnosis can be made from the first consultation and treatment can, therefore, start faster.

Additional tests will be prescribed at the first consultation.

When making an appointment, please tell the secretary that you would like an appointment for Peyronie’s disease. Slots are reserved to ensure consultations within a reasonable amount of time. In the event that the wait for an appointment exceeds one month, please send an email to who will take the necessary steps to free a slot within the month.






Doctor Marc Galiano


2 rue Dupuytren
75006 PARIS