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Early insertion of inflatable prosthesis for intractable ischemic priapism: our experience and review of the literature

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Abstract

A cohort of 20 patients with delayed priapism who underwent treatment at the Emergency Department of our academic referral centers between January 2002 and April 2010 was studied. Of these, 16 cases suffered from a low-flow priapism. A total of 6 cases were managed non-surgically, 10 required shunt surgery, and of these 5 were treated by early penile prosthesis surgery. Prostheses were easily implanted in all patients with a mean operative time of 94 min. No intraoperative complications and no infection were registered. All patients with an inflatable prosthesis complained a reduction in penile sensibility that lasted 3 months. All patients were satisfied with the results of surgery (International Index of Erectile Function Questionnaire-5, Q5 mean value 4), and all were successfully engaging in satisfactory sexual intercourses. No significant loss of penile length, neither apical erosion nor extrusion was recorded. Early insertion of a penile prosthesis is a simple and safe procedure in patients with ischemic priapism, which failed to respond to conservative management. Early insertion of a prosthesis helps to maintain adequate penile length, resolve priapism and, in the long term, it results in high satisfaction rates.

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References

  1. Eland IA, van der Lei J, Stricker BH, Sturkenboom MJ . Incidence of priapism in the general population. Urology 2001; 57: 970–972.

    Article  CAS  Google Scholar 

  2. Pryor J, Akkus E, Alter G, Jordan G, Lebret T, Levine L et al. Priapism. J Sex Med 2004; 1: 116–120.

    Article  Google Scholar 

  3. Nehra A . Priapism. Pathophysiology and non-surgical managment. In: Porst H, Buvat J (eds). Standard Practice in Sexual Medicine. Blackwell Publishing: Boston, MA, 2006, pp 174–179.

    Chapter  Google Scholar 

  4. Montague DK, Jarow J, Broderick GA, Dmochowski RR, Heaton JP, Lue TF et al. Members of the Erectile Dysfunction Guideline Update Panel; Americal Urological Association. American Urological Association guideline on the management of priapism. J Urol 2003; 170 (4 Part 1): 1318–1324.

    Article  Google Scholar 

  5. Spycher MA, Hauri D . The ultrastructure of the erectile tissue in priapism. J Urol 1986; 135: 142–147.

    Article  CAS  Google Scholar 

  6. Ul-Hasan M, El-Sakka AI, Lee C, Yen TS, Dahiya R, Lue TF . Expression of TGF-beta-1 mRNA and ultrastructural alterations in pharmacologically induced prolonged penile erection in a canine model. J Urol 1998; 160 (6 part1): 2263–2266.

    Article  CAS  Google Scholar 

  7. Broderick GA, Harkaway R . Pharmacologic erection: time-dependent changes in the corporal environment. Int J Impot Res 1994; 6: 9–16.

    CAS  PubMed  Google Scholar 

  8. Broderick GA, Gordon D, Hypolite J, Levine RM . Anoxia and corporal smooth muscles dysfunction. J Urol 1994; 151: 259–262.

    Article  CAS  Google Scholar 

  9. Kim NN, Kim JJ, Hypolite J, García-Díaz JF, Broderick GA, Tornheim K et al. Altered contractility of rabbit penile corpus cavernosum smooth muscle by hypoxia. J Urol 1996; 155: 772–778.

    Article  CAS  Google Scholar 

  10. Saenz de Tejada I, Kim NN, Daley JT, Royai R, Hypolite J, Broderick GA et al. Acidosis impairs rabbit trabecualr smooth muscle contractility. J Urol 1997; 157: 722–726.

    Article  CAS  Google Scholar 

  11. Moon DG, Lee DS, Kim JJ . Altered contractile response of penis under hypoxia with metabolic acidosis. Int J Impot Res 1999; 11: 265–271.

    Article  CAS  Google Scholar 

  12. Burnett . Priapism. In: Campbell's Urology, 9th edn. (Walsh PC, Retik AB, Vaughan ED, Wein AJ (eds)). Amsterdam: Elsevier.

  13. Pohl J, Pott B, Kleinhans G . Priapism. A three-phase concept of managment according to aetiology and prognosis. BJU Int 1986; 58: 113–118.

    Article  CAS  Google Scholar 

  14. Broderick GA, Harkway R . Pharmacological erection: time-dependent changes in the corporal environment. Int J Imp Res 1994; 6: 9–16.

    CAS  Google Scholar 

  15. Munarritz R, Wenn CC, McAuley I, Goldstein I, Traish A, Kim N . Management of ischemic priapism with high-dose intracavernosal phenylephrine: from bench to bedside. J Sex Med 2006; 3: 918–922.

    Article  Google Scholar 

  16. Muneer A, Minhas S, Freeman A, Kumar P, Ralph DJ . Investigating the effects of high dose phenylephrine in the management of prolonged ischemic priapism. J Sex Med 2008; 5: 2152–2159.

    Article  CAS  Google Scholar 

  17. Brant WO, Garcia MM, Bella AJ, Chi T, Lue TF . T-shaped shunt and intracavernous tunneling for prolonged ischemic priapism. J Urol 2009; 181: 1699–1705.

    Article  Google Scholar 

  18. Salem EA, El Aasser O . Management of ischemic priapism by penile prosthesis insertion: prevention of distal erosion. J Urol 2010; 183: 2300–2303.

    Article  Google Scholar 

  19. Lian W, Lv J, Cui W, Jin Z, Liu T, Li W et al. Al-Ghorab shunt plus intracavernous tunneling for prolonged ischemic priapism. J Androl 2010; 31: 466–471.

    Article  Google Scholar 

  20. Rees RW, Kalesi J, Minhas S, Peters J, Kell P, Ralph DJ . The management of low-flow priapism with the immediate insertion of a penile prosthesis. BJU Int 2002; 90: 893–897.

    Article  CAS  Google Scholar 

  21. Ralph DJ, Garaffa G, Muneer A, Freeman A, Rees R, Christopher AN et al. The immediate insertion of a penile prosthesis for acute ischaemic priapism. Eur Urol 2009; 56: 1033–1038.

    Article  Google Scholar 

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Correspondence to O Sedigh.

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We present our experience in the treatment of refractory ischemic priapism with early inflatable penile prosthesis insertion.

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Sedigh, O., Rolle, L., Negro, C. et al. Early insertion of inflatable prosthesis for intractable ischemic priapism: our experience and review of the literature. Int J Impot Res 23, 158–164 (2011). https://doi.org/10.1038/ijir.2011.23

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  • DOI: https://doi.org/10.1038/ijir.2011.23

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