A modified surgical approach to the Al‐Ghorab shunt – an anatomical basis

Dangle, Pankaj P.; Patel, Mitesh; Pandya, Lopa K.; Firlit, Casimir F.

doi:10.1111/j.1464-410x.2012.11253.x

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…Furthermore, whilst many studies demonstrate the efficacy of certain techniques, [26,34] few directly compare procedures and comparative studies that do exist yield inconclusive results. For example, a study comparing shunting procedures found Grayhack's had the best outcomes, however due to patient heterogeneity it was not possible to reach firm conclusions.…”

Section: Surgical Shuntingmentioning

confidence: 99%

Ischaemic priapism: A clinical review

Ridgley

Raison

Sheikh

et al. 2017

Turkish Journal of Urology

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Objective: Ischaemic priapism is a rare condition characterised by little or no cavernosal blood flow, pain and rigidity of the penis. Immediate intervention is required to restore blood flow, prevent necrosis and erectile dysfunction. This review was conducted to determine the best course of treatment and identify areas in current guidelines to which improvements could be made. PubMed, Ovid, MEDLINE (1946-December 2016 and the Cochrane Library were searched as sources for literature. Key studies in each of the areas of management were identified and analysed. Material and methods:Results: A total of 45 articles were reviewed. The first step in treatment should be aspiration of corporeal blood. Further studies are needed to make firm recommendations as to whether irrigation should follow, as currently literature is inconclusive. If this fails to cause detumescence, sympathomimetics should be injected. The sympathomimetic of choice is phenylephrine as it is effective, specific and causes minimal cardiovascular side effects. It should be injected at a concentration of 100-500 μg/mL, with 1 mL being injected every 3-5 minutes for up to an hour (maximum 1mg in an hour). Surgical shunting is the next step, except in the cases of delayed priapism (48-72 hours duration) where immediate penile prosthesis insertion may be considered more appropriate. Distal shunts should be performed first, followed by proximal ones to minimise damage leading to erectile dysfunction. There exists little evidence recommending one shunting procedure over another. The final intervention is insertion of a penile prosthesis. Literature suggests that an inflatable prosthesis inserted immediately will yield the greatest patient satisfaction. Conclusion:A review of the literature has highlighted areas in which further research needs to be done to make conclusive recommendations, including whether irrigation should accompany aspiration and efficacy of shunting procedures. Further studies are required to ensure that patients receive the treatment most likely to cause detumescence and maintain erectile function.

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Section: Surgical Shuntingmentioning

confidence: 99%

Ischaemic priapism: A clinical review

Ridgley

Raison

Sheikh

et al. 2017

Turkish Journal of Urology

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“…The therapeutic option was based on the diagnosis of the type of priapism. 3 Less than one third of IP cases respond to conservative treatment or the simple aspiration and washing of the corpora cavernosa with saline solution. 4 However, the success rate of washing the corpora cavernosa with sympathomimetic agents may reach 80%.…”

Section: Discussionmentioning

confidence: 99%

Urethrocutaneous fistula post-Al-Ghorab shunt

Paladino¹,

Wroclawski²,

Julio³

et al. 2014

CUAJ

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Priapism is a rare event that may be induced by clinical conditions and medications. Ischemic priapism (IP) is a compartment syndrome of the penis, and it constitutes a medical emergency that may cause significant morbidity on the erectile function in particular. We report a case of a 30-year-old male in his fourth episode of priapism. The aspiration and washing of the corpora cavernosa with saline solution were performed, followed by washing with adrenaline solution without resolution of the condition. Treatment was followed by the performance of the Al-Ghorab shunt procedure with dorsal incision of the glans. During follow-up, an area of necrosis distal to the incision was detected, and after the catheter removal on postoperative day 14, the patient developed a glandular dorsal urethrocutaneous fistula and meatal stenosis. The meatal stenosis was corrected by Johanson urethroplasty with a neo-meatus at the coronal sulcus, along with resection and debridement of the fistula tract and a three-layer closure.

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“…Like Winter's shunting, EbbehØj or Al-Ghorab is to create a corporoglanular shunt with a scalpel rather than a needle. 8 9 10 The proximal shunts are open surgical operations. 11 12 The surgical treatments are more invasive.…”

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confidence: 99%

Modified technique in treating recurrent priapism: a technique report

Chen

Sun

et al. 2015

Asian J Androl

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Recurrent ischemic priapism is a problem in clinical treatment. Most of the cases require more invasive surgery to shunt the blood stasis. We introduce a modified technique in treating recurrent ischemic priapism. The technique described is applied to acute ischaemic priapic episodes in patients with a history of stuttering priapism. It was carried out by a Winter's shunt combined with a continuous cavernosal irrigation system. Priapism was effectively resolved on the patients without recurrence. The four patients who received this treatment recovered most sexual function after 6 months follow-up.

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A modified surgical approach to the Al‐Ghorab shunt – an anatomical basis

Cited by 4 publications

References 9 publications

Ischaemic priapism: A clinical review

Ischaemic priapism: A clinical review

Urethrocutaneous fistula post-Al-Ghorab shunt

Modified technique in treating recurrent priapism: a technique report

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