What is the surgical procedure for priapism?
For patients with prolonged low-flow priapism, some authors recommend considering caverno-dorsal vein shunting (Barry shunt). In this procedure, the surgeon transects the superficial or deep dorsal vein of the penis and anastomoses it to the corpora cavernosa.
What is the drug of choice for priapism?
Intracavernosal phenylephrine is the drug of choice and first-line treatment of low-flow priapism because the drug has almost pure alpha-agonist effects and minimal beta activity. In short-term priapism (< 6 h), especially drug-induced cases, intracavernosal injection of phenylephrine alone may result in detumescence.
Why is phenylephrine used for priapism?
Further, the risk of post-priapism ED is lower when sympathomimetic agents are used [Montague et al. 2003]. Phenylephrine is the preferred sympathomimetic agent because of its lower risk profile for systemic cardiovascular adverse effects than other agents [Burnett and Bivalacqua, 2007].
What is a shunt for priapism?
Proximal shunts allow blood flow from the proximal corpora to the spongiosum and include the Quackels (perineal) and the Sacher (penoscrotal) techniques. Venous shunts allow blood flow from the corpora to a vein and include the Greyhack (saphenous vein) and the Barry (dorsal vein of the penis).
Can priapism be fixed?
Nonischemic priapism often goes away with no treatment. Because there isn't a risk of damage to the penis, your doctor might suggest a watch-and-wait approach. Putting ice packs and pressure on the perineum — the region between the base of the penis and the anus — might help end the erection.
Where do you inject priapism with phenylephrine?
Draw 0.5 mg of phenylephrine into a 27 gauge (G) syringe. Place the needle into the corpus cavernosum on the selected side, close to the base of the penis at the two or ten o'clock position. Aspirate a little to confirm that you are in the corpus, and then inject the phenylephrine.
How is high flow priapism treated?
How is priapism treated?
- Ice packs: Ice applied to the penis and perineum may reduce swelling.
- Surgical ligation: Used in some cases where an artery has been ruptured, the doctor will ligate (tie off) the artery that is causing the priapism in order to restore normal blood flow.