Canguven Onder, Cetinel Cihangir, Horuz Rahim, Tarhan Fatih, Hamarat Bilal, Goktas Cemal
Urology Clinics, Kartal Training and Research Hospital, Istanbul, Turkey.
Korean J Urol. 2013 Jun;54(6):394-8. doi: 10.4111/kju.2013.54.6.394. Epub 2013 Jun 12.
Ischemic priapism, a compartment syndrome, requires urgent treatment in order to nourish the corpora cavernosa. As the first step, aspiration of blood and irrigation of the cavernosal bodies is performed to prevent fibrotic activity and secure erectile capability. During aspiration, there are risks of cardiovascular side effects of adrenergic agonists. We aimed to evaluate a transient distal penile corporoglanular shunt technique in place of aspiration and irrigation techniques for treatment of early ischemic priapism.
A transient distal penile shunt was applied to 15 patients with early ischemic priapism between January 2011 and May 2012. Priapism duration, history, causes, pain, and any prior management of priapism were assessed in all patients. A complete blood count and penile Doppler ultrasonography were performed, which showed attenuated blood flow in the cavernosal artery. A sterile closed system blood collection set, which has two needles and tubing, was used for the transient distal penile shunt.
Ten of 15 patients with early ischemic priapism were successfully treated with this transient shunt technique. No additional procedures were needed after the resolution of rigidity in the 10 successfully treated patients.
The transient nature of this technique is an advantage over aspiration and irrigation in the treatment of early ischemic priapism. Our results indicate that the technique can be offered for patients with an ischemic priapism episode of no more than 7 hours.
缺血性阴茎异常勃起作为一种骨筋膜室综合征,需要紧急治疗以滋养海绵体。第一步是抽吸血液并冲洗海绵体,以防止纤维化活动并确保勃起功能。抽吸过程中,存在肾上腺素能激动剂引起心血管副作用的风险。我们旨在评估一种暂时性阴茎远端海绵体-尿道海绵体分流术,以替代抽吸和冲洗技术来治疗早期缺血性阴茎异常勃起。
2011年1月至2012年5月期间,对15例早期缺血性阴茎异常勃起患者实施了暂时性阴茎远端分流术。评估了所有患者的阴茎异常勃起持续时间、病史、病因、疼痛情况以及既往对阴茎异常勃起的任何处理措施。进行了全血细胞计数和阴茎多普勒超声检查,结果显示海绵体动脉血流减弱。使用一种带有两根针头和管道的无菌封闭式采血装置进行暂时性阴茎远端分流术。
15例早期缺血性阴茎异常勃起患者中有10例通过这种暂时性分流术成功治愈。10例成功治愈的患者阴茎勃起硬度消退后无需额外手术。
在治疗早期缺血性阴茎异常勃起方面,该技术的暂时性是优于抽吸和冲洗的一个优势。我们的结果表明,对于阴茎异常勃起发作不超过7小时的患者可以采用该技术。