Corporal "snake" maneuver: corporoglanular shunt surgical modification for ischemic priapism.
BACKGROUND
Current surgical shunting procedures for major ischemic priapism do not always effectively resolve acute presentations of this disorder.


OBJECTIVE
To evaluate a modification of the Al-Ghorab distal penile corporoglanular shunt surgery for ischemic priapism.


METHODS
Three previously potent men (48, 43, 40 years of age) presented with major ischemic priapism episodes (5, 2, and 6 days in duration, respectively), which were refractory to clinical management including sympathomimetic intracavernosal treatments, intracorporal aspiration and saline irrigation, and penile shunt surgery attempts. We offered a surgical technique for facilitating corporal blood evacuation by retrograde insertion of a cavernosal dilator through the excised tunical windows of the distal corpora cavernosa after transglanular incision.


METHODS
Clinical evaluation of priapism resolution and erection recovery.


RESULTS
All men achieved successful resolution of priapism, with meaningful erection recovery assessable in one man. Conclusions. The modified Al-Ghorab corporoglanular shunt surgery appears to offer an advantageous management approach to resolve ischemic priapism, particularly for cases refractory to first-line management.
Burnett
Arthur L
AL
Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA. Electronic address: aburnett@jhmi.edu.
Pierorazio
Phillip M
PM
Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
D000328:Adult; D006801:Humans; D007511:Ischemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000502:physiology; D010413:Penis / Q000098:blood supply* / Q000601:surgery*; D011317:Priapism / Q000209:etiology* / Q000601:surgery*