Determinism and Liability in Complication of Prostate Biopsy

Introduction Non-ischemic or high-flow priapism is derived from unregulated arterial inflow within the penis, which is significantly less common and, therefore, less well characterized than ischemic or low-flow priapism. Aim We collected the most recent available data and summarized the findings. Methods All literature related to non-ischemic priapism from 2000–2018 from several databases was reviewed, and 105 articles, including any relevant referenced articles, were ultimately included. Main Outcome Methods We evaluated modality success rates, need for repeat procedures, and effects on erectile function. Results 237 cases of non-ischemic priapism were evaluated. Approximately 27% of patients underwent observation or medical management as the first treatment modality, whereas 73% underwent intervention without observation or medical management beforehand. Angiographic embolization with temporary agents was the most common intervention and generally resulted in both moderate resolution of non-ischemic priapism and moderate preservation of baseline erectile function. Patients who underwent embolization with permanent agents experienced higher rates of resolution, as well as lower rates of erectile dysfunction (ED). Conclusion Most of the literature is in the form of case reports and small case series, thus limiting the quality and quantity of evidence available to draw decisive conclusions. However, from the available data, it is reasonable to presume that patients can undergo a trial of conservative management, then pursue embolization first with temporary agents. The analysis of the data demonstrated ED rates were higher with temporary agents than permanent agents. The literature quotes ED rates as low as 5% when using temporary agents and 39% with permanent agents. Our results were, in fact, the opposite, with higher ED rates when using temporary agents vs permanent (17–33% vs 8–17%). Further studies are required to better characterize the success and outcomes of angioembolization.

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The Challenge of Difficult Catheterization in Men: A Novel Technique and Review of the Literature

Gardi¹,

Balta²,

Repele³

et al. 2013

UIJ

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Determinism and Liability in Complication of Prostate Biopsy

Cited by 3 publications

References 14 publications

Systematic Review of Complications of Prostate Biopsy

Systematic Review of Complications of Prostate Biopsy

An Update on Non-Ischemic Priapism

The Challenge of Difficult Catheterization in Men: A Novel Technique and Review of the Literature

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