title: Semi-rigid penile prosthesis as a salvage management of idiopathic ischemic stuttering priapism.
abstract: BACKGROUND
  Priapism is the persistent erection resulting from dysfunction of the mechanisms that regulate penile swelling, stiffness, and sagging. It is a full or partial erection that persists for a period more than 4 hours beyond sexual stimulation and/or orgasm or is unrelated to sexual stimulation. Ischemic priapism should be managed in a step-by-step fashion.
  
  
  OBJECTIVE
  To demonstrate step-by-step management of stuttering refractory ischemic priapism. We report a case of stuttering refractory ischemic priapism. Moreover, we reviewed different approaches to priapism management in the literature.
  
  
  METHODS
  A 53-year-old male presented with a painful erection of 29 hours' duration, probably caused by consumption of alcohol. The penile blood gas showed a pH of 7.08, PCO2 of 75 mmHg and PO2 of 39 mmHg. Aspiration was followed by irrigation of an α-adrenergic, Winter and T-shunt operations were preformed, and finally a semi-rigid penile prosthesis was implanted to overcome the refractory stuttering ischemic priapism.
  
  
  CONCLUSIONS
  In case of stuttering refractory ischemic priapism, immediate implantation of a penile prosthesis is a simple and effective procedure that manages both the acute episode and the inevitable erectile dysfunction that would otherwise occur, while preserving penile length.
authors.affiliation: Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Kiel, Germany.
authors.forename: Amr A
authors.initials: AA
authors.lastname: Faddan
authors.affiliation: Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Kiel, Germany.
authors.forename: Alexey V
authors.initials: AV
authors.lastname: Aksenov
authors.affiliation: Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Kiel, Germany.
authors.forename: Carsten M
authors.initials: CM
authors.lastname: Naumann
authors.affiliation: Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Kiel, Germany.
authors.forename: Klaus P
authors.initials: KP
authors.lastname: Jünemann
authors.affiliation: Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Kiel, Germany.
authors.forename: Daniar K
authors.initials: DK
authors.lastname: Osmonov
keywords: penile prosthesis; priapism; shunting operation; stuttering priapism