PD42-05 DOES PENOSCROTAL DECOMPRESSION OUTPERFORM CORPOROGLANULAR TUNNELING FOR SURGICAL MANAGEMENT OF PROLONGED ISCHEMIC PRIAPISM?

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD42-05 DOES PENOSCROTAL DECOMPRESSION OUTPERFORM CORPOROGLANULAR TUNNELING FOR SURGICAL MANAGEMENT OF PROLONGED ISCHEMIC PRIAPISM? Maia E. VanDyke, Wesley J. Smith, Brian T. Langford, Benjamin N. Breyer, Faysal A. Yafi, David W. Barham, Niels V. Johnsen, Levi C. Holland, Benjamin M. Dropkin, Mikkel Fode, Bryce P. Franzen, Steven J. Hudak, and Allen F. Morey Maia E. VanDykeMaia E. VanDyke More articles by this author , Wesley J. SmithWesley J. Smith More articles by this author , Brian T. LangfordBrian T. Langford More articles by this author , Benjamin N. BreyerBenjamin N. Breyer More articles by this author , Faysal A. YafiFaysal A. Yafi More articles by this author , David W. BarhamDavid W. Barham More articles by this author , Niels V. JohnsenNiels V. Johnsen More articles by this author , Levi C. HollandLevi C. Holland More articles by this author , Benjamin M. DropkinBenjamin M. Dropkin More articles by this author , Mikkel FodeMikkel Fode More articles by this author , Bryce P. FranzenBryce P. Franzen More articles by this author , Steven J. HudakSteven J. Hudak More articles by this author , and Allen F. MoreyAllen F. Morey More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003352.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prolonged ischemic priapism (PIP) presents a rare and challenging urological condition, often requiring advanced surgical maneuvers for resolution. We sought to evaluate current practice patterns in the management of this challenging condition using a multi-institutional survey. METHODS: A 38-question, web-based survey was distributed to clinically active urologic surgeons including members of the Society of Genitourinary Reconstructive Surgeons (GURS) and the Sexual Medicine Society of North America (SMSNA). PIP was defined as priapism duration of at least 24 hours prior to presentation. Questions highlighted experience with and perceived efficacy of adjunctive maneuvers including distal shunting, corporoglanular tunneling (CGT) and penoscrotal decompression (PSD). Also queried were surgeons’ impressions of the prevalence of erectile dysfunction after priapism surgery. RESULTS: One hundred fifteen responses were received following survey distribution. Tunneling procedures (CGT and PSD) were the favored first-line intervention for PIP over implants (80/114 tunneling vs. 11/114 implant, p<.001). Respondents were more likely to have performed CGT than PSD (110/113 for CGT vs. 74/112 for PSD, p<.001), but among those who had performed both, PSD was felt to be more than twice as effective at resolving PIP (33/63, 52% Very or Extremely Effective for PSD, vs. 13/64, 20% for CGT; p<.001, Figure 1). For patients with recurrent priapism after CGT, PSD was the preferred salvage procedure for 46% of surgeons (46/99) while immediate implant was favored by 40% (40/99, p=.390). Regarding sexual function, a similar number of respondents who had performed both tunneling procedures felt that at least half of patients regained adequate sexual function after either CGT or PSD (27/61, 44% vs. 25/60, 42%; p=.773). CONCLUSIONS: PSD is perceived by surgeons as more effective than CGT for prolonged ischemic priapism and is commonly chosen as a salvage procedure when CGT fails. Many surgeons feel that patients regain erectile function after tunneling procedures, avoiding the need for expensive prosthetics. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1112 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Maia E. VanDyke More articles by this author Wesley J. Smith More articles by this author Brian T. Langford More articles by this author Benjamin N. Breyer More articles by this author Faysal A. Yafi More articles by this author David W. Barham More articles by this author Niels V. Johnsen More articles by this author Levi C. Holland More articles by this author Benjamin M. Dropkin More articles by this author Mikkel Fode More articles by this author Bryce P. Franzen More articles by this author Steven J. Hudak More articles by this author Allen F. Morey More articles by this author Expand All Advertisement PDF downloadLoading ...