1226 EVALUATION OF A NI-TI SHAPE MEMORY ALLOY FOR USE IN A NOVEL PENILE PROSTHESIS

Abstract

Priapism 48 hours (n 28, median duration 96 hours, range 48168). All cases had an unsuccessful aspiration and intracorporal administration of sympathomimetics and underwent ‘T-shunt’ procedure and intracavernous tunnelling with a size 8 Hegar dilator each side. All patients completed an IIEF5 questionnaire pre and 3 months post operativelyand all had cavernosal muscle biopsies taken at the time of shunting. RESULTS: Resolution of the priapism using T shunting and snake maneuver occurred in all patients with a priapism duration 24hrs, in 55% of patients with a duration of 24-48hrs and in 35% of patients with a duration 48hrs. The average IIEF-5 score in all of the patients preoperatively was 24. After a median follow-up of 3 months, the IIEF-5 score is shown in the table. All of the patients, who developed severe erectile dysfunction, had a penile prosthesis implantation. Those with moderate and mild ED are under treatment with PDE5 inhibitors. CONCLUSIONS: The success of the ‘T-shunt’ technique with snake tunnelling is dependent on the duration of priapism. When 24hrs the results are favourable although erectile dysfunction is still present in 50%. Those with a duration of 48hrs the technique usually fails to resolve the priapism and all end up with corporal fibrosis due to smooth muscle necrosis. T shunting is a useful technique in early priapism but after 48 hrs should not be offered as it neither treats the priapism nor changes the inevitable outcome of corporal fibrosis.