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Extracorporeal transient distal penile corporoglanular shunt in early ischemic priapism treatment
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doi: 10.1590/S1677-5538.IBJU.2014.05.19
Onder Canguven 1,2, Raidh A. Talib 2
1 Kartal Teaching and Research Hospital, Istanbul, Turkey; 2 Hamad General Hospital, Doha, Qatar
ABSTRACT
Purpose: Ischemic priapism, which is a compartment syndrome, needs urgent treatment in order to nourish corpora cavernosa. As the first step, the aspiration of blood and/or the irrigation of the cavernosal bodies are performed to prevent fibrotic activity and secure erectile capability. While performing aspiration and irrigation, there are some risks of the procedure in which most refrained one is cardiovascular side effects of adrenergic agonists. We aimed to evaluate extracorporeal transient distal penile corporoglanular shunt technique in place of aspiration/ irrigation techniques for early ischemic priapism treatment.
Materials and Methods: In this transient shunt technique, a sterile closed system blood collection set (BD Vacutainer, Cat. No.: 367282; NJ, USA), which has two 21G needles, was used. The length of the needle and tubing was 19 mm. (0.75 inch) and 178 mm. (7 inches), respectively. This blood collection set was designed to be used not only for blood collection but can also be used for short term infusions (maximum 2 hours).
Results: Ten patients out of fifteen with early ischemic priapism were successfully treated with this transient shunt technique. The permanent detumescence achieved in the first 10 minutes in nine out of fifteen patients.No additional procedure needed after the disappearance of rigidity in successfully treated patients. The permanent detumescence achieved in the first 10 minutes in nine out of fifteen patients.
Conclusions: We demonstrated that this extracorporeal transient shunt technique gets some advantages over aspiration and irrigation in early ischemic priapism treatment. Our results indicate thatthe presented technique to be offered for the patients with an ischemic priapism episode of no more than 7 hours.
ARTICLE INFO
Available at:
www.brazjurol.com.br/videos/september_october_2014/Canguven_710_711video.htm
Int Braz J Urol. 2014; 40 (Video #14): 710-711
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Submitted for publication:
August 04, 2014
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Accepted after revision:
October 20, 2014
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Correspondence address:
Onder Canguven, MD
Hamad General Hospital
Department of Urology
Andrology Clinic
3050 Doha, Qatar
Telephone:+ 974 443-91864
E-mail: ocanguven@yahoo.com
Editorial comment
In the video by Dr. Wallen JJ and colleagues, an elegant way to improve the cosmesis and perceived penile length of patients undergoing partial penectomy for penile cancer is presented. Previous reports (1,2) demonstrated its utility in penile prosthetic surgery.
Partial penectomy gives a good local control of the cancer, but with a potential effect on self-image.
This technique gives the opportunity to improve cosmesis with a perceived increase length that will help on self-image.
References
- Carrion R: Ventral phalloplasty. J Sex Med. 2010;7:2914-7.
- Hakky TS, Suber J, Henry G, Smith D, Bradley P, Martinez D, Carrion RE. Penile enhancement procedures with simultaneous penile prosthesis placement. Adv Urol. 2012;2012:314612.
Dr. Jose Jaime Correa
Urologic Oncology Department
Hospital Pablo Tobon Uribe
Medellin, Colombia
E-mail: jocorreao@uces.edu.co
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