Urethrocutaneous fistula post-Al-Ghorab shunt

Abstract

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.

Successful Treatment of Detachment of the Incision after Al-Ghorab Procedure: A Case Report and Review of Literature

“…The patients were treated with surgical debridement. Paladino et al (2014) reported necrosis and urethrocutaneous fistula due to Al-Ghorab procedure in a patient who was on valproic acid, clonazepam, haloperidol and levomepromazine for the treatment of schizophrenia. An inadvertent injury of the glandular urethra occurred during the Al-Ghorab procedure.…”