Open AccessHigh-flow priapism after T-shunt and tunneling in a patient with ischemic priapism
Author(s) -
Valerio Vagi,
Alessandro Franceschelli,
Giorgio Gentile,
Franco Palmisano,
Matteo Renzulli,
Alberta Cappelli,
R Golfieri,
Fulvio Colombo
Publication year - 2020
Publication title -
turkish journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.347
H-Index - 8
eISSN - 2149-3057
pISSN - 2149-3235
DOI - 10.5152/tud.2020.20144
Subject(s) - priapism , medicine , shunt (medical) , penile prosthesis , erectile dysfunction , sexual stimulation , pathophysiology , tumescence , cardiology , shunting , surgery , ischemia , anesthesia
Priapism is defined as an erection lasting for more than 4 hours without sexual stimulation. It is grouped into 3 subtypes: ischemic (low-flow), nonischemic (high-flow), and stuttering priapism. Herein we describe a rare event of high-flow state as a result of conversion from a delayed ischemic priapism after a T-shunt with tunneling. To our knowledge, there is a paucity of reported cases, and the pathophysiology is still unclear. Clinicians should be aware of this uncommon but known scenario in case of penile tumescence after shunting procedure for ischemic priapism; penile Doppler ultrasound and selective pudendal angiography represent essential tools for diagnosis and treatment of this rare condition. In delayed ischemic priapism persisting for >36 hours, patients should be counseled about the irreversible damages of the cavernosal muscle and erectile dysfunction to consider an early penile prosthesis implantation with a satisfactory long-term functionaloutcome, decreasing the risks related to a distal shunt procedure.