Priapism: Management and functional outcomes

Short Communication

Priapism: Management and functional outcomes

Nizar Cherni ¹
Abdallah Chaachou ¹
Wael Ferjaoui ^2*
Samir Ghozzi ¹
Mohamed Dridi ¹

1Department of Urology, Military Hospital of Tunisia.

2Department of General surgery, Military Hospital of Tunisia.

*Corresponding Author: Nizar Cherni, Department of Urology, Military Hospital of Tunisia.

Citation: Cherni N., Chaachou A., Ferjaoui W.,Ghozzi S., Dridi M.. (2023). Priapism: Management and functional outcomes. Journal of BioMed Research and Reports, BRS Publishers. 2(3); DOI: 10.596572837-4681.brs.23.018

Copyright: © 2023 Wael Ferjaoui, this is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received: March 24, 2023 | Accepted: April 17, 2023 | Published: April 25, 2023

Abstract

The aim of treatment is to obtain detumescence, avoid recurrence and avoid erectile sequelae.

Keywords: priapism; fibrosis; therapeutic

Introduction

Priapism is a rare but serious condition as its spontaneous evolution is towards permanent impotence and poses therapeutic problems depending on the delay in management.

Materials & Methods

Retrospective study of 5 patients treated and followed at the urology department of the Military Hospital of Tunis during 4 years, from 2016 to 2020.

Results and Discussion

3 adults (26, 35, and 42 years old) with an average age of 22 years. The delay of the management varied from 12 to 72 hours, three patients consulted before 36 hours and the other two after 36 hours. The clinical examination concluded that all 5 patients had an irreducible and painful erection.

One case had induration of the distal third of the penis and the other had fibrosis of the corpora cavernosa which respects the base of the penis.

The severity of priapism and its sequelae depends on the time to management and the type of priapism.

The aim of treatment is to obtain detumescence, avoid recurrence and avoid erectile sequelae.

In the case of arterial priapism, invasive surgery has been abandoned in favor of selective embolisation performed during selective internal pudendal arteriography.

In the case of venous priapism, treatment is based on puncturing the corpora cavernosa and injecting alpha stimulants. Surgery consists of creating a cavernous shunt.

Evolution

The risk of sequelae of impotence due to fibrosis of the corpora cavernosa depends on the delay in treatment. After 48 hours the risk is around 60%. The risk of occurrence of dyserection also depends on the age of the patient: 25% at 20 years and 80% at 60 years.

The prognosis is better in high flow priapism and those occurring in sickle cell patients: 14% impotence in sickle cell children.

Conclusion

If most medical or surgical techniques allow obtaining a detumescence of the penis, impotence is nevertheless, the frequent consequence of priapism. Early treatment seems to be the best way to prevent impotence.

References

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Publisher | Google Scholor

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