Priapism shunting procedures

Three patients developed priapism after taking cocaine or non-prescription weight loss formulations containing ephedrine (216). Intracavemous injection of phenylephrine and irrigation with heparinized saline, followed by an Al-Ghorab shunt procedure, was effective. 

In this case it was felt that the 20% fat emulsion had increased platelet activity, which was already increased before the start of therapy, and that this had predisposed to the development of priapism. The authors pointed out that a shunt procedure should be performed as soon as possible if erectile capacity is to be preserved. 

A 47-year-old man presented with a 4-day history of priapism and moderate pain. Several brief but otherwise similar episodes had occurred during the previous month. He had a history of depression and had been taking sertrahne 200 mg/day and dexamfetamine 10 mg/ day. He received intracorporeal methoxamine, but when this proved ineffective he was treated with intracorporeal adrenaline and a shunt procedure. However, detumescence was incomplete. At fohow-up after several weeks the priapism had resolved and he had not become impotent (a significant risk in cases of... 

Vascular Surgery for Impotence 137 Circumcision 139 Penile Augmentation Procedures 140 Shunt Surgery for Ischemic Priapism 140 Sex Reassignment Surgery 141 Urethral Surgery 141... 

---