Approach to Late-Presenting Priapism: Our Clinical Experiences

Year 2026, Issue: Advanced Online Publication, 13 - 22

Ayhan Arslan , Erdal Benli , Ahmet Anıl Acet , Ahmet Yüce , Abullah Çırakoğlu

https://doi.org/10.19127/mbsjohs.1694643

https://izlik.org/JA84XD49BP

Abstract

Objective: Priapism is a penile erection lasting more than four hours with or without sexual stimulation. Ischemic priapism lasting more than 48 hours is difficult to resolve with corporal aspiration, irrigation, and sympathomimetic injection. In such cases, shunt surgery may be necessary. The need for complicated surgeries such as penile prosthesis arises due to the development of fibrosis and erectile dysfunction. Our aim in this study is to present how we manage cases presenting to our clinic with late-stage priapism, accompanied by literature, and to draw attention to this issue.
Method: We reviewed the retrospective analyses of patients with late-stage priapism who presented to our hospital between 2020 and 2024. We recorded the patient's demographic information and the procedures and surgeries performed.
Results: We reached the data of five patients presenting with late-stage priapism. Although these patients were treated with intracavernous sympathomimetic irrigation along with aspiration, all of them required shunt surgery. T-shunt procedures were performed in all cases. The snake maneuver was applied in 2 of the 5 patients. A total of three patients developed erectile dysfunction. One of them underwent a penile prosthesis...
Conclusion: According to our experience, it is tough to achieve detumescence in delayed priapism cases with only corporal aspiration and sympathomimetic injection, so we think that shunt surgeries and penile prostheses should be applied without delay.

Keywords

Priapism , ischemia , shunt surgery

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