MP84-04 PRACTICE PATTERNS AND ATTITUDES AMONG UROLOGISTS IN THE MANAGEMENT OF ACUTE ISCHEMIC PRIAPISM

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Penis/Testis/Urethra: Benign Disease & Malignant Disease II1 Apr 2018MP84-04 PRACTICE PATTERNS AND ATTITUDES AMONG UROLOGISTS IN THE MANAGEMENT OF ACUTE ISCHEMIC PRIAPISM Jessica Dai, Omer Raheem, and Thomas Walsh Jessica DaiJessica Dai More articles by this author , Omer RaheemOmer Raheem More articles by this author , and Thomas WalshThomas Walsh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2772AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite national guidelines on the management of priapism, there remains widespread variation in practice patterns. Moreover, in many areas, acute ischemic priapism is managed by Emergency Medicine providers. To date, the practice patterns and attitudes of urologists regarding the management of this entity are poorly characterized. METHODS From July to September 2017, urologists in both academic and community-based practices were asked to anonymously complete an online survey detailing their management practices for acute ischemic priapism and attitudes toward its management by trainees and non-urology providers. Survey participants included urology residents, fellows, and practicing urologists. Participants were contacted through the Society for the Study of Male Reproduction (SSMR), state urological societies, and direct solicitation. Responses from pediatric urologists were excluded. RESULTS 58 individuals responded to the survey and included 44 practicing urologists, 5 fellows, and 9 urology residents. Every American Urological Association (AUA) Section was represented, and 39.7% of respondents practiced in a non-academic setting. 50% recommend oral agents (terbutaline, pseudoephedrine, or others) in the treatment of acute ischemic priapism. After 24 hours of duration, 83% of respondents would begin treatment with corporal aspiration and/or irrigation, vs. 74% at 48 hours and 65% beyond 72 hours. At 24 hours, 3.4% would begin treatment with a distal shunt alone, vs. 8.5% at 48 hours and 13.8% after 72 hours. 91% of respondents thought Emergency Medicine physicians in the community should manage cases of straightforward priapism. The majority believed Emergency Medicine residents should be managing cases of acute ischemic priapism, either with Urology assistance (24.1%) or independently (56.9%). 29% preferred to be contacted by Emergency Medicine providers only after unsuccessful corporal aspiration and irrigation, and 39.7% only after unsuccessful intracavernosal injections. CONCLUSIONS Management of acute ischemic priapism overall appears relatively consistent, despite variation in initial therapy for priapism of longer durations. Many urologists use oral therapy despite national recommendations against this practice. There is strong support for independent management of straightforward acute ischemic priapism cases by Emergency Medicine physicians and trainees among urologists. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1125-e1126 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Jessica Dai More articles by this author Omer Raheem More articles by this author Thomas Walsh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...