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Ischaemic priapism: A clinical review
Joanne Ridgley1, Nicholas Raison2, M Iqbal Sheikh3
1GKT School of Medicine, King's College London, London, UK.
Turkish Journal of Urology
|March 9, 2017
Summary
Ischaemic priapism requires immediate intervention to restore blood flow and prevent complications. Treatment involves aspiration, phenylephrine injection, surgical shunting, and potentially penile prosthesis insertion for optimal outcomes.
Area of Science:
- Urology
- Emergency Medicine
- Andrology
Background:
- Ischaemic priapism is a medical emergency characterized by prolonged penile erection with no or minimal blood flow.
- Prompt treatment is crucial to prevent penile necrosis and long-term erectile dysfunction.
Purpose of the Study:
- To review current literature on ischaemic priapism management.
- To identify optimal treatment pathways and areas for guideline improvement.
Main Methods:
- A comprehensive literature search was conducted using PubMed, Ovid, MEDLINE, and the Cochrane Library.
- Key studies concerning the management of ischaemic priapism were identified and analyzed.
Main Results:
- Initial treatment involves aspiration of corporeal blood; irrigation efficacy remains inconclusive.
- Phenylephrine is the recommended sympathomimetic for injection due to its efficacy and safety profile.
- Surgical shunting (distal first) or immediate penile prosthesis insertion are subsequent steps, with inflatable prostheses offering high patient satisfaction.
Conclusions:
- Further research is needed to establish definitive recommendations for irrigation and shunting procedures.
- Optimizing treatment protocols is essential for successful detumescence and preservation of erectile function.
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