title: Barry shunt for treatment of a 76-hour stuttering priapism without subsequent erectile dysfunction.
abstract: BACKGROUND
  This paper reports treatment of a 76-hour low-flow priapism with a shunting procedure that was first described by Barry in 1976. We were able to observe the preservation of erectile function despite the long period of ischemia. A review of the literature shows that there are few reports of erectile function recovery after a priapism of similar duration.
  
  
  METHODS
  A 42-year-old patient presented with a 76-hour priapism, probably caused by consumption of alcohol and illegal drugs. A Barry Shunt procedure was performed. The erectile function of the patient was assessed by means of International Index of Erectile Function score over a follow-up period of 30 months. Moreover, we reviewed different surgical options for treatment of priapism in the literature.
  
  
  RESULTS
  Partial return of erection without sexual arousal occurred on two occasions during the 10-day hospitalization, but was treated by manipulation of the penis, ie, by milking the tumescence into the shunt. After 3 months, the shunt was still palpable as a subcutaneous swelling. Six months postoperatively, the residual swelling had disappeared. The International Index of Erectile Function score was of 21 without phosphodiesterase type 5 inhibitors after a follow-up of 2.5 years.
  
  
  CONCLUSIONS
  Barry shunt is an effective alternative surgical option for the treatment of low-flow priapism. In the case of our patient, it was also effective after a 76-hour-lasting priapism.
authors.affiliation: Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: Daniar Kurmanbekovich
authors.initials: DK
authors.lastname: Osmonov
authors.affiliation: Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: Aleksey
authors.initials: A
authors.lastname: Aksenov
authors.affiliation: Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: Andrea Nathaly
authors.initials: AN
authors.lastname: Guerra Sandoval
authors.affiliation: Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: Almut
authors.initials: A
authors.lastname: Kalz
authors.affiliation: Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: Klaus Peter
authors.initials: KP
authors.lastname: Juenemann
keywords: cavernovenous shunt; erectile function; low flow priapism; surgical treatment of stuttering priapism