Medical and Clinical Case Reports
Open AccessDiagnosis and Treatment of Ischemic Priapism in the Past 20 Years: What is New?
Authors: Ariel Hernandez Gutierrez, Rodrigo Cartaxo, João Antonio Pereira-Correia, Valter José Fernandes Muller.
Abstract
Introduction: Ischemic priapism (IP) is the most common form of Priapism. IP causes time-dependent damage to smooth muscle, which can lead to significant morbidity including permanent erectile dysfunction (ED), penile shortening, penile curvature, and loss of girth, without immediate intervention. In our study we revisited the most current developments in the diagnosis and treatment of this condition.
Methods: We searched the PubMed, CINAHL, ScienceDirect, LILACS, SciELO, and Google Scholar databases using the MeSH terms “priapism surgery,” “corpus cavernosum”, “shunt priapism,” “ischemic priapism,” and “penile prosthesis.” The search was restricted to studies published in English, Portuguese, and Spanish between January 2005 and February 2025. After the deletion of duplicates, two researchers screened the abstracts of the retrieved articles. Articles selected for review were read by at least two researchers. Their notes were compared and arranged thematically.
Results: We ultimately analyzed 15 studies evaluating the most current types of priapism, epidemiological chararacteristics, diagnostic methods and surgical treatment.
Conclusion: IP affects mainly young men and can have devastating physical and psychological consequences if no devastating treated appropriately. Decisive management is needed to prevent time-dependent damage to the cavernous tissue and preserve sexual function. When conservative measures are not effective, distal shunts should be used with or without tunneling maneuvers. Currently, proximal shunt use and venous anastomosis are not recommended. In patients with IP episodes lasting more than 48 or 72 h and in refractory cases in which shunt use fails, penile prosthesis implantation is the most appropriate treatment option.
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