Creation of Caverno-Glandular Shunt for Treatment of Priapism

Chary, K.S.N.; Rao, M.S.; Kumar, Sheetanshu; Palaniswamy, R.; Chandrasekar, D.; Vaidyanathan, S; Jain, Sudhir

doi:10.1159/000473261

Cited by 5 publications

(1 citation statement)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Analysis of the literature has shown that scalpel-based shunts (eg, Ebbehoj, Al Ghorab, Lue T Shunt) provide higher success than needle-based (ie, Winter's) shunts. 5,15,18,24–38 Another potential factor relevant to comparative success rates is duration of priapism prior to the intervention of interest. In one study of patients managed with tunneling, detumescence was achieved in 100%, 34%, and 0% of cases treated before 24 hours, at or beyond 48 hours, and at or beyond 96 hours, respectively.…”

Section: Guideline Statementsmentioning

confidence: 99%

Acute Ischemic Priapism: An AUA/SMSNA Guideline

et al. 2021

View full text Add to dashboard Cite

Purpose: Priapism is a persistent penile erection that continues hours beyond, or is unrelated to, sexual stimulation and results in a prolonged and uncontrolled erection. Given its time-dependent and progressive nature, priapism is a situation that both urologists and emergency medicine practitioners must be familiar with and comfortable managing. Acute ischemic priapism, characterized by little or no cavernous blood flow and abnormal cavernous blood gases (ie, hypoxic, hypercarbic, acidotic) represents a medical emergency and may lead to cavernosal fibrosis and subsequent erectile dysfunction. Materials and Methods: A comprehensive search of the literature was performed by Emergency Care Research Institute for articles published between January 1, 1960 and May 1, 2020. Searches identified 2948 potentially relevant articles, and 2516 of these were excluded at the title or abstract level for not meeting inclusion criteria for any key question. Full texts for the remaining 432 articles were reviewed, and ultimately 137 unique articles were included in the report. Results: This Guideline was developed to inform clinicians on the proper diagnosis and surgical and non-surgical treatment of patients with acute ischemic priapism. This Guideline addresses the role of imaging, adjunctive laboratory testing, early involvement of urologists when presenting to the emergency room, discussion of conservative therapies, enhanced data for patient counseling on risks of erectile dysfunction and surgical complications, specific recommendations on intracavernosal phenylephrine with or without irrigation, the inclusion of novel surgical techniques (eg, tunneling), and early penile prosthesis placement. Conclusions: All patients with priapism should be evaluated emergently to identify the sub-type of priapism (acute ischemic versus non-ischemic) and those with an acute ischemic event should be provided early intervention. Treatment of the acute ischemic patient must be based on patient objectives, available resources, and clinician experience. As such, a single pathway for managing the condition is oversimplified and no longer appropriate. Using a diversified Abbreviations and Acronyms AUA [ American Urological Association ED [ erectile dysfunction ICI [ intracavernosal injection MAOI [ monoamine oxidase inhibitors PDUS [ penile duplex Doppler ultrasonography SMSNA [ Sexual Medicine Society of North America

show abstract

Section: Guideline Statementsmentioning

confidence: 99%

Acute Ischemic Priapism: An AUA/SMSNA Guideline

et al. 2021

View full text Add to dashboard Cite

show abstract

Partial segmental thrombosis of corpus cavernosum: Case report and review of world literature

Horger

Wingo

Keane

2005

Urology

View full text Add to dashboard Cite

Surgical and minimally invasive treatment of ischaemic and non-ischaemic priapism: a systematic review by the EAU Sexual and Reproductive Health Guidelines panel

et al. 2022

View full text Add to dashboard Cite

Surgical treatments for ischemic priapism (IP) include shunts or penile implants. Non-ischemic priapism (NIP) is usually the result of penile/perineal trauma causing an arterial fistula and embolisation may be required. We conducted a systematic review on behalf of the EAU Sexual and Reproductive health Guidelines panel to analyse the available evidence on efficacy and safety of surgical modalities for IP and NIP. Outcomes were priapism resolution, sexual function and adverse events following surgery. Overall, 63 studies (n=923) met inclusion criteria up to September 2021. For IP (n=702), surgery comprised distal (n=274), proximal shunts (n=209) and penile prostheses (n=194). Resolution occurred in 18.7-100% for distal, 5.7-100% for proximal shunts and 100% for penile prostheses. Potency rate was 20-100% for distal, 11.1-77.2% for proximal shunts, and 26.3-100% for penile prostheses, respectively.Patient satisfaction was 60-100% following penile prostheses implantation. Complications were 0-42.5% for shunts and 0-13.6% for IPP. For NIP (n=221), embolisation success was 85.7-100% and potency 80-100%. The majority of studies were retrospective cohort studies. Risk of bias was high. Overall, surgical shunts have acceptable success rates in IP. Proximal/venous shunts should be abandoned due to morbidity/ED rates. In IP >48 hours, best outcomes are seen with penile prostheses implantation . Embolisation is the mainstay technique for NIP with high resolution rates and adequate erectile function.

show abstract

Creation of Caverno-Glandular Shunt for Treatment of Priapism

Cited by 5 publications

References 12 publications

Acute Ischemic Priapism: An AUA/SMSNA Guideline

Acute Ischemic Priapism: An AUA/SMSNA Guideline

Partial segmental thrombosis of corpus cavernosum: Case report and review of world literature

Surgical and minimally invasive treatment of ischaemic and non-ischaemic priapism: a systematic review by the EAU Sexual and Reproductive Health Guidelines panel

Contact Info

Product

Resources

About