Distal corpus cavernosum fibrosis and erectile dysfunction secondary to non-ischaemic priapism


Submitted: September 29, 2015
Accepted: September 29, 2015
Published: September 30, 2015
Abstract Views: 2154
PDF: 964
SUPPLEMENTARY MATERIAL: 454
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Authors

  • Evangelos Zacharakis Department of Urology, Guy’s Hospital, Kings College London; Department of Urology, University College London Hospitals, United Kingdom.
  • David J. Ralph Department of Urology, University College London Hospitals, United Kingdom.
  • Miles Walkden Department of Radiology, University College London Hospitals, United Kingdom.
  • Asif Muneer Department of Urology, University College London Hospitals, United Kingdom.
Non-ischaemic priapism is a rare type of priapism and is associated with penile or perineal trauma. The absence of ischaemia should theoretically prevent smooth muscle necrosis and corporal fibrosis which occurs in ischaemic priapism. The aim of this study was to first report a patient series with non-ischaemic priapism that developed distal corpus cavernosum fibrosis and erectile dysfunction. Over a 5 year period, a cohort of 6 patients diagnosed with non-ischaemic priapism presented to a single centre. The diagnosis was based on a clinical history, penile examination with confirmation using a combination of cavernosal blood gas analysis, colour duplex ultrasonography of the penis and angiography. Patients were followed up in clinic at regular intervals with clinical examination and repeat imaging. Following a median follow up of 4 weeks (range 2-12) the patients reported either the development of erectile dysfunction with distal penile flaccidity. Five patients required the use of PDE-5 inhibitors to achieve full tumescence. The remaining patient eventually underwent insertion of a penile prosthesis due to the failure of pharmacotherapies. Based on these findings we suggest that superselective embolisation of non-ischaemic priapism cases occasionally should be performed after a shorter period of conservative treatment.

Zacharakis, E., Ralph, D. J., Walkden, M., & Muneer, A. (2015). Distal corpus cavernosum fibrosis and erectile dysfunction secondary to non-ischaemic priapism. Archivio Italiano Di Urologia E Andrologia, 87(3), 258–259. https://doi.org/10.4081/aiua.2015.3.258

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