Research and Reports in Urology (Jan 2022)
Penile Prosthesis Implantation in Refractory Ischaemic Priapism: Patient Selection and Special Considerations
Abstract
Marco Capece,1 Marco Falcone,2 Tommaso Cai,3 Alessandro Palmieri,1 Andrea Cocci,4 Roberto La Rocca1 1Department of Urology, AOU Federico II, University Hospital, Naples, Italy; 2Department of Neurourology, A.O.U. Città della Salute e della Scienza di Torino - Unità Spinale Unipolare, Turin, Italy; 3Ospedale Santa Chiara, Trento, Italy; 4Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, ItalyCorrespondence: Alessandro PalmieriDepartment of Neuroscience, Reproductive Science and Odontostomatology, University Federico II of Naples, via S.Pansini 5, Naples, 80131, ItalyTel +39 081 746 2611Fax +39 081 746 4311Email [email protected]: Ischemic priapism accounts for more than 95% of all priapic episodes. It has to be considered a urological emergency because its time extension may lead to necrosis of smooth muscle cells of the corpora cavernosa, resulting in a complete erectile dysfunction, penile shortening and loss of girth. In the present systematic review, we perform an up-to-date literature search for patients suffering from refractory ischemic priapism who undergo penile prosthesis implantation with particular interests to the patients characteristics. The conservative management of the priapic episode consists of a sympathomimetic agent in the first istance. Failure or recurrence of priapism following these conservative measures is an indication for surgical management. Shunt procedures between the corpora cavernosa and the neighbouring structures are often used first line; however, in refractory ischemic priapism the success rate is minimal. In such cases (> 48 h) an indication of immediate placement of a penile prosthesis could be the best solution.Keywords: refractory ischemic priapism, erectile dysfunction, priapism, penile prosthesis
