Korean J Urol.  2013 Jun;54(6):394-398.

Transient Distal Penile Corporoglanular Shunt as an Adjunct to Aspiration and Irrigation Procedures in the Treatment of Early Ischemic Priapism

• Canguven O
• Cetinel C
• Horuz R
• Tarhan F
• Hamarat B
• Goktas C

Abstract

PURPOSE
Ischemic priapism, a compartment syndrome, requires urgent treatment in order to nourish the corpora cavernosa. As the first step, aspiration of blood and irrigation of the cavernosal bodies is performed to prevent fibrotic activity and secure erectile capability. During aspiration, there are risks of cardiovascular side effects of adrenergic agonists. We aimed to evaluate a transient distal penile corporoglanular shunt technique in place of aspiration and irrigation techniques for treatment of early ischemic priapism.
MATERIALS AND METHODS
A transient distal penile shunt was applied to 15 patients with early ischemic priapism between January 2011 and May 2012. Priapism duration, history, causes, pain, and any prior management of priapism were assessed in all patients. A complete blood count and penile Doppler ultrasonography were performed, which showed attenuated blood flow in the cavernosal artery. A sterile closed system blood collection set, which has two needles and tubing, was used for the transient distal penile shunt.
RESULTS
Ten of 15 patients with early ischemic priapism were successfully treated with this transient shunt technique. No additional procedures were needed after the resolution of rigidity in the 10 successfully treated patients.
CONCLUSIONS
The transient nature of this technique is an advantage over aspiration and irrigation in the treatment of early ischemic priapism. Our results indicate that the technique can be offered for patients with an ischemic priapism episode of no more than 7 hours.

Keyword

Penile disease; Penile erection; Priapism; Urological surgical procedures

MeSH Terms

Adrenergic Agonists
Arteries
Blood Cell Count
Compartment Syndromes
Humans
Hypogonadism
Imidazoles
Male
Mitochondrial Diseases
Needles
Nitro Compounds
Ophthalmoplegia
Penile Diseases
Penile Erection
Priapism
Resin Cements
Ultrasonography, Doppler
Urologic Surgical Procedures
Adrenergic Agonists
Hypogonadism
Imidazoles
Mitochondrial Diseases
Nitro Compounds
Ophthalmoplegia
Resin Cements

Figure

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  FIG. 1 One of the needles was inserted in the corpus cavernosum and the needle on the other end of the set was inserted in the glans.

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  FIG. 2 Corporal bodies were squeezed to increase the pressure inside the corpus cavernosa.

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