(417) Erectile Function after Treatment for Non-ischemic Priapism

Abstract

Abstract Introduction Non-ischemic priapism (NIP) is a rare subtype of priapism that typically arises from a straddle injury leading to the formation of an arterial-sinusoidal fistula, which results in partial penile tumescence. NIP can be managed conservatively, with selective arterial embolization, or, rarely, with surgical arterial ligation. These treatments have varying rates of success and post-treatment erectile dysfunction (ED), but there is a paucity of studies that include long-term outcomes. We present long term follow up of 23 three patients in a large centre offering all interventions. Objective Follow up 23-patients presenting with non-ischemic priapism, evaluating long term erectile function in both those who did and didn’t require intervention in the form of embolization. Methods We conducted a single-centre retrospective cross-sectional study looking at erectile function (EF) in a cohort of 23 patients over a median follow-up of 61 months. Patients’ EF was assessed using the erectile function domain (IIEF-EF) of the British Association of Urological Surgeons (BAUS) International Index of Erectile Function (IIEF) questionnaire, and ED was defined as a score ≤ 25 and/or the use of pharmacological adjuncts to assist EF. This is the largest and longest study in this field of its type. Results o Our cohort had a median IIEF-EF score of 28, and 4 patients (17.4%) reported using adjuncts. 21 patients were treated with embolization, and 2 were managed conservatively. o 91.3% required treatment with embolization, 17.4% needed adjunctive agents o 4.3% reported suffering a further episode of priapism (single iatrogenic episode) o 0% ED in conservative management group, 47.6% ED in embolization group. Conclusions We had a higher ED rate with embolization compared to the literature (47.6% vs 15-22%). Although no patients treated conservatively had ED at follow-up, there were only 2 patients in this group. Our study’s validity is negatively affected by many factors: its retrospective nature, a small sample size, and confounding from a heterogeneous group of patients. Ultimately, NIP is a rare condition with good treatment outcomes which are constantly improving and evolving. Disclosure No