The journal of sexual medicine · 2026
Non-surgical vs surgical management for major ischemic priapism of 36 hours duration.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
El-Achkar Adnan, Arbuiso Alyssa, Filho Nilson Marquardt, Cheaib Joseph, Florissi Isabella, Grutman Aurora, Burnett Arthur L
Аннотация
BACKGROUND: Ischemic priapism persisting beyond 36 hours frequently results in irreversible corporal injury and erectile dysfunction, raising questions about whether surgical intervention is even necessary or worthwhile in these cases.
AIM: To compare outcomes of non-surgical vs surgical management in patients with ischemic priapism lasting ≥36 hours.
METHODS: We conducted a retrospective review of patients treated for ischemic priapism persisting ≥36 hours at our institution between January 2005 and October 2024. Patients were categorized into two cohorts based on initial treatment strategy: (1) non-surgical-aspiration with or without irrigation and phenylephrine injection and (2) surgical-T-shunt or Al-Ghorab shunt procedures, with or without corporal snaking, or penile prosthesis placement during the same admission. Demographic and clinical variables were compared using Wilcoxon-Mann-Whitney, Fisher's exact, and chi-squared tests.
OUTCOMES: Primary outcomes included reintervention and readmission rates; secondary outcomes included penile fibrosis and deformity.
RESULTS: Seventy-six patients were included: 38 treated non-surgically and 38 surgically. Baseline characteristics, including age, comorbidities, and priapism etiology, were similar between groups. Median duration of priapism at presentation did not differ significantly (36 vs 48 hours, P = 0.41). The non-surgical group had a significantly higher rate of readmission and reintervention compared to the surgical group (66.7% vs 10.4%, P < 0.01). Deforming penile fibrosis was more frequent in the non-surgical group (18.5% vs 7.9%), although this difference was not statistically significant (P = 0.309).
CLINICAL IMPLICATIONS: Conservative non-surgical management for prolonged ischemic priapism is associated with higher retreatment rates and complications, suggesting that a more definitive surgical approach may be more effective in managing these cases.
STRENGTHS AND LIMITATIONS: This study provides real-world comparative data on management strategies for prolonged ischemic priapism in a consecutive patient cohort. Limitations include its retrospective, single-center design, small sample size, and limited long-term follow-up, which precluded assessment of erectile function and prosthesis outcomes.
CONCLUSION: In cases of ischemic priapism lasting >36 hours, non-surgical treatment is associated with higher failure and complication rates, supporting early surgical intervention to improve outcomes and reduce morbidity.
AIM: To compare outcomes of non-surgical vs surgical management in patients with ischemic priapism lasting ≥36 hours.
METHODS: We conducted a retrospective review of patients treated for ischemic priapism persisting ≥36 hours at our institution between January 2005 and October 2024. Patients were categorized into two cohorts based on initial treatment strategy: (1) non-surgical-aspiration with or without irrigation and phenylephrine injection and (2) surgical-T-shunt or Al-Ghorab shunt procedures, with or without corporal snaking, or penile prosthesis placement during the same admission. Demographic and clinical variables were compared using Wilcoxon-Mann-Whitney, Fisher's exact, and chi-squared tests.
OUTCOMES: Primary outcomes included reintervention and readmission rates; secondary outcomes included penile fibrosis and deformity.
RESULTS: Seventy-six patients were included: 38 treated non-surgically and 38 surgically. Baseline characteristics, including age, comorbidities, and priapism etiology, were similar between groups. Median duration of priapism at presentation did not differ significantly (36 vs 48 hours, P = 0.41). The non-surgical group had a significantly higher rate of readmission and reintervention compared to the surgical group (66.7% vs 10.4%, P < 0.01). Deforming penile fibrosis was more frequent in the non-surgical group (18.5% vs 7.9%), although this difference was not statistically significant (P = 0.309).
CLINICAL IMPLICATIONS: Conservative non-surgical management for prolonged ischemic priapism is associated with higher retreatment rates and complications, suggesting that a more definitive surgical approach may be more effective in managing these cases.
STRENGTHS AND LIMITATIONS: This study provides real-world comparative data on management strategies for prolonged ischemic priapism in a consecutive patient cohort. Limitations include its retrospective, single-center design, small sample size, and limited long-term follow-up, which precluded assessment of erectile function and prosthesis outcomes.
CONCLUSION: In cases of ischemic priapism lasting >36 hours, non-surgical treatment is associated with higher failure and complication rates, supporting early surgical intervention to improve outcomes and reduce morbidity.