title: Outcome and erectile function following treatment of priapism: An institutional experience.
abstract: BACKGROUND
  Priapism has a devastating consequence on the sexual function of men if not promptly managed. We are presenting our experience of the treatment of priapism and the status of sexual function even following successful detumescence achieved after treatment.
  
  
  METHODS
  Nineteen patients, who presented with priapism from January 2012 to December 2014, were included in the study. After obtaining a detailed history; color Doppler ultrasonography of penis and blood gas analysis of the initial corporal aspirate were done to ascertain the type of priapism. Standard protocol in our institute for management of priaprism was to start with conservative treatment by corporal aspiration and intracorporeal injection (ICI) of phenylephrine. On the failure of conservative management, distal shunts were performed. Proximal shunts were performed on the failure of distal shunt procedures. Erectile function was evaluated with International Index of Erectile Function-5 questionnaire on admission and during follow-up.
  
  
  RESULTS
  All the patients had ischemic type priapism. Age of the patients ranged from 22 to 55 years. Duration of priapism varied from 20 to 480 h (mean 96.7). Etiologies attributed were; over-the-counter sildenafil use, chlorpromazine, opium intake and intracorporeal papaverine injection, chronic myeloid leukemia, and idiopathic. Five patients had preserved erectile function during follow-up. Preservation of normal erectile function following aspiration and ICI, proximal and distal shunt procedures were 66.7%, 18.1% and 20%, respectively.
  
  
  CONCLUSIONS
  Patients with late presentation and those patients requiring higher treatment modalities (e.g., proximal shunts) for achieving detumescence will subsequently have a poor erectile function. These patients should be counseled about the early penile prosthesis placement during initial surgical management.
authors.affiliation: Department of Urology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India.
authors.forename: Dilip Kumar
authors.initials: DK
authors.lastname: Pal
authors.affiliation: Department of Urology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India.
authors.forename: Deepak Kumar
authors.initials: DK
authors.lastname: Biswal
authors.affiliation: Department of Urology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India.
authors.forename: Bastab
authors.initials: B
authors.lastname: Ghosh
keywords: Erectile dysfunction; impotence; penile implant; penile prosthesis; priapism
references.citation: Eur Urol. 2009 Dec;56(6):1033-8
references.pmid: 18930579
references.citation: Ther Adv Urol. 2014 Dec;6(6):230-44
references.pmid: 25435917
references.citation: Br J Radiol. 2012 Nov;85 Spec No 1:S79-85
references.pmid: 22960245
references.citation: Postgrad Med J. 2006 Feb;82(964):89-94
references.pmid: 16461470
references.citation: Asian J Androl. 2013 Jan;15(1):75-8
references.pmid: 22922321
references.citation: Cent European J Urol. 2011;64(2):80-3
references.pmid: 24578869
references.citation: J Urol. 2013 Oct;190(4):1275-80
references.pmid: 23583536
references.citation: BJU Int. 2002 Feb;89(3):285-90
references.pmid: 11856112
references.citation: Int J Impot Res. 2011 Mar-Apr;23(2):76-80
references.pmid: 21451542
references.citation: Int J Impot Res. 2002 Aug;14(4):245-50
references.pmid: 12152112
references.citation: Can Urol Assoc J. 2009 Aug;3(4):304-311
references.pmid: 19672444
references.citation: Eur Urol. 2014 Feb;65(2):480-9
references.pmid: 24314827
references.citation: Curr Urol Rep. 2010 Nov;11(6):405-13
references.pmid: 20878277
references.citation: J Urol. 2003 Oct;170(4 Pt 1):1318-24
references.pmid: 14501756
references.citation: Curr Urol Rep. 2002 Dec;3(6):492-8
references.pmid: 12425873
references.citation: J Urol. 1986 Jan;135(1):142-7
references.pmid: 3941454
references.citation: J Urol. 2003 Sep;170(3):883-6
references.pmid: 12913722
references.citation: Urology. 2001 May;57(5):970-2
references.pmid: 11337305
references.citation: J Sex Med. 2010 Jan;7(1 Pt 2):476-500
references.pmid: 20092449
references.citation: BJU Int. 2002 Dec;90(9):893-7
references.pmid: 12460352
references.citation: Urol J. 2010 Summer;7(3):174-7
references.pmid: 20845293
references.citation: Adv Urol. 2012;2012:672624
references.pmid: 22811705
references.citation: J Sex Med. 2013 Jan;10(1):180-94
references.pmid: 22462660
references.citation: Nat Rev Urol. 2009 May;6(5):262-71
references.pmid: 19424174
references.citation: Int J Impot Res. 1999 Dec;11(6):319-26
references.pmid: 10637462
references.citation: Urology. 1988 Oct;32(4):385-6
references.pmid: 3051631