MP66-16 THE 10-YEAR PRIAPISM CONSULT EXPERIENCE: IDENTIFYING CLEARER TARGETS FOR PRIAPISM INTERVENTION

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality Improvement & Patient Safety III (MP66)1 Apr 2020MP66-16 THE 10-YEAR PRIAPISM CONSULT EXPERIENCE: IDENTIFYING CLEARER TARGETS FOR PRIAPISM INTERVENTION Yooni Yi*, Julian Wan, Miriam Hadj-Moussa, and Bahaa Malaeb Yooni Yi*Yooni Yi* More articles by this author , Julian WanJulian Wan More articles by this author , Miriam Hadj-MoussaMiriam Hadj-Moussa More articles by this author , and Bahaa MalaebBahaa Malaeb More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000941.016AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The true incidence of priapism is poorly understood and largely abstracted from large insurance databases without patient-level data. The objective of this study was to better understand the priapism consult experience within our center and determine findings that may guide clinical translational efforts. METHODS: A retrospective review of urology consultations for priapism at a tertiary care center was performed from July 2008 - June 2018. Patients seen for routinely scheduled clinic visits were excluded. Patient factors and demographics were obtained by chart review. The duration and type of priapism, prior interventions, acute interventions, and work-up were evaluated to understand the events surrounding a single consult. RESULTS: Urology was consulted 198 times for 83 unique patients (average age: 35 years; average duration of priapism: 15 hours). Priapism etiology was due to sickle cell (43%), erectogenic medications (12%), anti-psychotic medications (8%) and a large number with an unknown etiology (29%). A bedside procedure (irrigation, phenylephrine injection or distal shunt) was performed in 66% of consults. No intervention was required for 27% of patients due to self-resolution, high-flow priapism, non-acute episode of ischemic priapism, or presence of malleable prosthesis. Urgent operations were completed in 7% (n=13), of which only four of the patients had proximal shunts performed. About 25% of the consults were transfers from an outside hospital (OSH) (average duration of priapism = 39 hours). Amongst transfers, 16 patients (32%) had no procedures done prior to transfer. Interestingly, only 22 patients were responsible for about 70% of the consultations. In the group of patients with multiple consults, there was a higher percentage of sickle cell disease, stuttering priapism and need for bedside procedures (Table 1). CONCLUSIONS: A minority of patients account for the majority of consultations indicating a need for improved outpatient management of stuttering priapism. Another major target for improvement of care is the timely transfer of patients from the OSH as prolonged duration can lead to irreversible erectile dysfunction. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e989-e990 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yooni Yi* More articles by this author Julian Wan More articles by this author Miriam Hadj-Moussa More articles by this author Bahaa Malaeb More articles by this author Expand All Advertisement PDF downloadLoading ...