An update on the management algorithms of priapism during the last decade
Priapism is a persistent penile erection lasting longer than 4 hours, that needs emergency management. This disorder can induce irreversible erectile dysfunction. There are three subtypes of priapism: ischemic, non-ischemic, and stuttering priapism. If the patient has ischemic priapism (IP) of less...
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PAGEPress Publications
2022-06-01
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| Series: | Archivio Italiano di Urologia e Andrologia |
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| Online Access: | https://www.pagepressjournals.org/index.php/aiua/article/view/10616 |
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| author | Mohamad Moussa Mohamad Abou Chakra Athanasios Papatsoris Athanasios Dellis Michael Peyromaure Nicolas Barry Delongchamps Hugo Bailly Sabine Roux Ahmad Abou Yassine Igor Duquesne |
| author_facet | Mohamad Moussa Mohamad Abou Chakra Athanasios Papatsoris Athanasios Dellis Michael Peyromaure Nicolas Barry Delongchamps Hugo Bailly Sabine Roux Ahmad Abou Yassine Igor Duquesne |
| author_sort | Mohamad Moussa |
| collection | DOAJ |
| description |
Priapism is a persistent penile erection lasting longer than 4 hours, that needs emergency management. This disorder can induce irreversible erectile dysfunction. There are three subtypes of priapism: ischemic, non-ischemic, and stuttering priapism. If the patient has ischemic priapism (IP) of less than 24-hours (h) duration, the initial management should be a corporal blood aspiration followed by instillation of phenylephrine into the corpus cavernosum. If sympathomimetic fails or the patient has IP from 24 to 48h, surgical shunts should be performed. It is recommended that distal shunts should be attempted first. If distal shunt failed, proximal, venous shunt, or T-shunt with tunneling could be performed. If the patient had IP for 48 to 72h, proximal and venous shunt or T-shunt with tunneling is indicated, if those therapies failed, a penile prosthesis should be inserted. Non-ischemic priapism (NIP) is not a medical emergency and many patients will recover spontaneously. If the NIP does not resolve spontaneously within six months or the patient requests therapy, selective arterial embolization is indicated. The goal of the management of a patient with stuttering priapism (SP) is the prevention of future episodes. Phosphodiesterase type 5 (PDE5) inhibitor therapy is considered an effective tool to prevent stuttering episodes but it is not validated yet. The management of priapism should follow the guidelines as the future erectile function is dependent on its quick resolution. This review briefly discusses the types, pathophysiology, and diagnosis of priapism. It will discuss an updated approach to treat each type of priapism.
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| first_indexed | 2024-04-12T09:46:46Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1124-3562 2282-4197 |
| language | English |
| last_indexed | 2024-04-12T09:46:46Z |
| publishDate | 2022-06-01 |
| publisher | PAGEPress Publications |
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| series | Archivio Italiano di Urologia e Andrologia |
| spelling | doaj.art-8f841b083ec84d639b1196b350068ecb2022-12-22T03:37:56ZengPAGEPress PublicationsArchivio Italiano di Urologia e Andrologia1124-35622282-41972022-06-0194210.4081/aiua.2022.2.237An update on the management algorithms of priapism during the last decadeMohamad Moussa0Mohamad Abou Chakra1Athanasios Papatsoris2Athanasios Dellis3Michael Peyromaure4Nicolas Barry Delongchamps5Hugo Bailly6Sabine Roux7Ahmad Abou Yassine8Igor Duquesne9Department of Urology, Al Zahraa Hospital, University Medical Center, Lebanese University, BeirutDepartment of Urology, Al Zahraa Hospital, University Medical Center, Lebanese University, Beirut2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens; Department of Surgery, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens Department of Urology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, ParisDepartment of Urology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, ParisDepartment of Urology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, ParisDepartment of Urology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, ParisInternal Medicine, Staten Island University Hospital, Staten Island, NYDepartment of Urology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris Priapism is a persistent penile erection lasting longer than 4 hours, that needs emergency management. This disorder can induce irreversible erectile dysfunction. There are three subtypes of priapism: ischemic, non-ischemic, and stuttering priapism. If the patient has ischemic priapism (IP) of less than 24-hours (h) duration, the initial management should be a corporal blood aspiration followed by instillation of phenylephrine into the corpus cavernosum. If sympathomimetic fails or the patient has IP from 24 to 48h, surgical shunts should be performed. It is recommended that distal shunts should be attempted first. If distal shunt failed, proximal, venous shunt, or T-shunt with tunneling could be performed. If the patient had IP for 48 to 72h, proximal and venous shunt or T-shunt with tunneling is indicated, if those therapies failed, a penile prosthesis should be inserted. Non-ischemic priapism (NIP) is not a medical emergency and many patients will recover spontaneously. If the NIP does not resolve spontaneously within six months or the patient requests therapy, selective arterial embolization is indicated. The goal of the management of a patient with stuttering priapism (SP) is the prevention of future episodes. Phosphodiesterase type 5 (PDE5) inhibitor therapy is considered an effective tool to prevent stuttering episodes but it is not validated yet. The management of priapism should follow the guidelines as the future erectile function is dependent on its quick resolution. This review briefly discusses the types, pathophysiology, and diagnosis of priapism. It will discuss an updated approach to treat each type of priapism. https://www.pagepressjournals.org/index.php/aiua/article/view/10616Priapismischemic priapismnon-ischemic priapismstuttering priapism |
| spellingShingle | Mohamad Moussa Mohamad Abou Chakra Athanasios Papatsoris Athanasios Dellis Michael Peyromaure Nicolas Barry Delongchamps Hugo Bailly Sabine Roux Ahmad Abou Yassine Igor Duquesne An update on the management algorithms of priapism during the last decade Archivio Italiano di Urologia e Andrologia Priapism ischemic priapism non-ischemic priapism stuttering priapism |
| title | An update on the management algorithms of priapism during the last decade |
| title_full | An update on the management algorithms of priapism during the last decade |
| title_fullStr | An update on the management algorithms of priapism during the last decade |
| title_full_unstemmed | An update on the management algorithms of priapism during the last decade |
| title_short | An update on the management algorithms of priapism during the last decade |
| title_sort | update on the management algorithms of priapism during the last decade |
| topic | Priapism ischemic priapism non-ischemic priapism stuttering priapism |
| url | https://www.pagepressjournals.org/index.php/aiua/article/view/10616 |
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