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2017 ; 9
(ä): 175-179
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Management of refractory ischemic priapism: current perspectives
#MMPMID28920056
Capece M
; Gillo A
; Cocci A
; Garaffa G
; Timpano M
; Falcone M
Res Rep Urol
2017[]; 9
(ä): 175-179
PMID28920056
show ga
OBJECTIVES: The aim of the present manuscript is to review the current literature
on priapism, focusing on the state-of-the-art knowledge of both the diagnosis and
the treatment of the refractory ischemic priapism (IP). METHODS: Pubmed and
EMBASE search engines were used to search for words "priapism", "refractory
priapism", "penile prosthesis", "diagnosis priapism", "priapism treatment",
"penile fibrosis", "priapism therapy". All the studies were carefully examined by
the authors and then included in the review. RESULTS: First-line treatment
involves ejaculation, physical exercise and cold shower followed by corporal
blood aspiration and injection of ?-adrenoceptor agonists. Subsequently, a distal
or proximal shunt may be considered. If none of the treatment is effective or the
priapism episode lasts >48 hours penile prosthesis implantation could be the only
option to solve the priapism and treat the ongoing erectile dysfunction.
CONCLUSION: The management of IP is to achieve detumescence of persistent penile
erection and to preserve erectile function after resolution of the priapic
episode. On the other hand, penile fibrosis and following shortening should be
prevented. Early penile prosthesis implantation in patients with refractory IP is
able to solve both the priapic episode and prevent the otherwise certain penile
shortening. Penile prosthesis implantation is the actual gold standard of care in
cases of refractory IP.