[Therapy of priapism (author's transl)]

Due to the poor knowledge concerning etiology and pathophysiology of priapism the treatment necessarily remains largely symptomatic. There are two main therapeutic aims: 1. The penile detumescence in order to relief the often severe local pain and 2. the preservation of the compromised erectile potency. To compare different therapeutic principles a follow-up of our own relatively large series of 55 cases of priapism ((1962-1980) is presented. Conservation of potency was the criterion of therapeutic success. In idiopathic priapism 50% of the patients kept their potency after shunt-operations, whereas in priapism of known origin ("secondary priapism" due to ileofemoral thrombosis, leukemia, hemodialysis) after different treatment methods (thrombolytic pharmacotherapy, shunt-operations) the result nearly always was a loss of potency. Considering the lower technical expense and the lower rate of complications today the transglandular cavernosum-spongiosum (cavernoglandular) shunt (Ebbehøj-Winter) is to be preferred to the cavernosum-saphenous (Grayhack) and cavernosum-spongiosum-shunt (Quackels).