Outcome and erectile function following treatment of priapism: An institutional experience

Abstract

Introduction:Priapism has a devastating consequence on the sexual function of men if not promptly managed. We are presenting our experience of the treatment of priapism and the status of sexual function even following successful detumescence achieved after treatment.Materials and Methods:Nineteen patients, who presented with priapism from January 2012 to December 2014, were included in the study. After obtaining a detailed history; color Doppler ultrasonography of penis and blood gas analysis of the initial corporal aspirate were done to ascertain the type of priapism. Standard protocol in our institute for management of priaprism was to start with conservative treatment by corporal aspiration and intracorporeal injection (ICI) of phenylephrine. On the failure of conservative management, distal shunts were performed. Proximal shunts were performed on the failure of distal shunt procedures. Erectile function was evaluated with International Index of Erectile Function-5 questionnaire on admission and during follow-up.Results:All the patients had ischemic type priapism. Age of the patients ranged from 22 to 55 years. Duration of priapism varied from 20 to 480 h (mean 96.7). Etiologies attributed were; over-the-counter sildenafil use, chlorpromazine, opium intake and intracorporeal papaverine injection, chronic myeloid leukemia, and idiopathic. Five patients had preserved erectile function during follow-up. Preservation of normal erectile function following aspiration and ICI, proximal and distal shunt procedures were 66.7%, 18.1% and 20%, respectively.Conclusion:Patients with late presentation and those patients requiring higher treatment modalities (e.g., proximal shunts) for achieving detumescence will subsequently have a poor erectile function. These patients should be counseled about the early penile prosthesis placement during initial surgical management.

Priapism as the initial sign in hematologic disease: Case report and literature review

“…On the other hand, surgical prosthesis implantation are the last rung and should be considered in patients with refractory or recurrent priapism associated with erectile dysfunction [ 10 , 14 ]. The main step is establishing specific treatment of the underlying disease, as well as early hematological consultation [ 10 , 15 ] ( Table 3 ).…”

Access of men with sickle cell disease and priapism in emergency services

“…This interferes with the feeling of life continuity, it appears as something unexpected and unwanted and can be related as the last chance to keep the erectile and sexual function. Erectile dysfunction is predictable in 90% of the ischemic priapism cases lasting more than 24 hours 1 , and the duration interferes with the preservation of the function 11 . Waiting for a spontaneous resolution of priapism and the delay in seeking professional help in emergency units were common in the reports, indicating the need for investment in education to understand the disease, its complications and the self-care of these men since their childhood, when the first episodes of priapism occur, in addition to informing their families to provide support.…”

“…The number of participants was established by the data saturation criterion. As "priapism" refers to the Greek god of fertility, Priapus 11 , to ensure anonymity and secrecy, names of Greek deities were drawn and attributed to portray the participants. The projective technique of story-theme drawing was used to produce the data.…”

Role of Penile Prosthesis in Priapism: A Review

“…Patients who fail to achieve detumescence following initial shunting should undergo reoperation to resolve their RIP. Unfortunately, erectile function recovery rates tend to decrease in cases requiring use of higher order interventions (proximal and distal shunts) and ED is often reported even after successful detumescence [ 48 49 ]. If patients are interested in resuming sexual intercourse following the resolution of their care, they inevitably require PP due to the increased severity of their ED.…”