Tausch Timothy J, Zhao Lee C, Morey Allen F, Siegel Jordan A, Belsante Michael J, Seideman Casey A, Flemons James R
Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA.
J Sex Med. 2015 Mar;12(3):824-6. doi: 10.1111/jsm.12803. Epub 2014 Dec 23.
Refractory ischemic priapism (RIP) can be difficult to treat, consuming significant healthcare-related resources. Acute insertion of a malleable penile prosthesis (MPP) has been reported as an effective therapy that treats the priapism and restores sexual function.
We report our 6-year, urban public hospital experience with acute insertion of MPP in patients with RIP.
We retrospectively reviewed the records of patients receiving MPPs for RIP from 2007 to 2013. Data analyzed included duration of erection, number of emergency room (ER) visits, hospital admissions, days of hospitalization, and postoperative course. Costs were estimated using standard Medicare reimbursement rates.
Healthcare-related costs of treatment of RIP episodes in men presenting to our institution.
During the study period, 14 men underwent MPP placement acutely for refractory priapism. Thirteen presented with RIP, and one had stuttering priapism over a 14-day hospitalization. Etiologies included sickle cell anemia (4/13, 29%), medication-induced (3/14, 21%), and idiopathic (7/14, 50%). Average preoperative duration of RIP was 82 hours with considerable consumption of health-care resources (average US $83,818 estimated cost, 4 ER visits [range 1-27], 2 hospital admissions [range 1-5], 1.5 shunt procedures [range 1-3], 5 irrigation and drainage procedures using phenylephrine injection [range 2-20], and 5 hospital admission days [range 2-14]). All patients were discharged within 24 hours of MPP surgery.
The management of RIP is associated with multiple ER visits, prolonged hospital admissions, and significant resource utilization. MPP insertion is efficacious for the immediate resolution of refractory priapism, with potential cost and resource benefits.
难治性缺血性阴茎异常勃起（RIP）治疗困难，耗费大量医疗相关资源。据报道，急性植入可屈性阴茎假体（MPP）是一种有效的治疗方法，可治疗阴茎异常勃起并恢复性功能。
我们报告在城市公立医院对RIP患者急性植入MPP的6年经验。
我们回顾性分析了2007年至2013年因RIP接受MPP治疗的患者记录。分析的数据包括勃起持续时间、急诊室（ER）就诊次数、住院次数、住院天数及术后病程。费用按标准医疗保险报销率估算。
在我院就诊的男性RIP发作的医疗相关治疗费用。
研究期间，14名男性因难治性阴茎异常勃起接受了MPP急性植入。13例为RIP，1例在14天住院期间出现间歇性阴茎异常勃起。病因包括镰状细胞贫血（4/13，29%）、药物性（3/14，21%）和特发性（7/14，50%）。RIP术前平均持续时间为82小时，耗费大量医疗资源（估计平均费用83,818美元，4次急诊就诊[范围1 - 27次]，2次住院[范围1 - 5次]，1.5次分流手术[范围1 - 3次]，5次使用去氧肾上腺素注射的冲洗和引流手术[范围2 - 20次]，以及5天住院天数[范围2 - 14天]）。所有患者在MPP手术后24小时内出院。
RIP的治疗与多次急诊就诊、长期住院及大量资源利用相关。MPP植入对于难治性阴茎异常勃起的即刻解决有效，具有潜在的成本和资源效益。
