Abou Chawareb Elia, Hammad Muhammed A M, Barham David W, Lumbiganon Supanut, Azad Babak K, Osmonov Daniar, Yafi Faysal A
Department of Urology, University of California, Irvine, CA, USA.
Department of Urology, Brooke Army Medical Center, Fort Sam Houston, Houston, TX, USA.
Int J Impot Res. 2025 Jan;37(1):27-32. doi: 10.1038/s41443-024-00900-y. Epub 2024 May 8.
Ischemic priapism is a urological emergency which may lead to irreversible erectile dysfunction. One of the accepted treatments is penile prosthesis implantation. Given the scarcity of studies directly comparing timing of penile prosthesis insertion after ischemic priapism, consensus remains elusive. We aim to compare different studies in the literature concerning advantages and disadvantages of early versus delayed inflatable penile prosthesis following ischemic priapism. We analyzed 8 articles that investigated immediate and delayed inflatable penile prosthesis placement after ischemic priapism. Early inflatable penile prosthesis placement is associated with better outcomes, including pain relief, priapism resolution, penile shortening prevention, and quicker sexual activity resumption. However, it still carries a high risk of complications like edema, infection, and distal perforations. Delayed inflatable penile prosthesis insertion poses surgical challenges due to the potential for extensive corporal fibrosis. Comparative analyses have shown elevated complication rates in patients with ischemic priapism who undergo delayed inflatable penile prosthesis insertion, as opposed to those with early insertion. In studies reporting complications rates, the total complication rate in the early group was 3.37%, significantly lower than the delayed group (37.23%). Most studies support the superiority of early inflatable penile prosthesis placement following ischemic priapism over delayed placement. Further research is, however, needed to establish a global consensus on timing of prosthesis insertion.
缺血性阴茎异常勃起是一种泌尿外科急症，可能导致不可逆的勃起功能障碍。公认的治疗方法之一是阴茎假体植入。鉴于直接比较缺血性阴茎异常勃起后阴茎假体植入时机的研究较少，目前尚未达成共识。我们旨在比较文献中关于缺血性阴茎异常勃起后早期与延迟植入可膨胀阴茎假体的优缺点的不同研究。我们分析了8篇关于缺血性阴茎异常勃起后立即和延迟植入可膨胀阴茎假体的文章。早期植入可膨胀阴茎假体与更好的结果相关，包括疼痛缓解、阴茎异常勃起消退、预防阴茎缩短以及更快恢复性活动。然而，它仍然具有较高的并发症风险，如水肿、感染和远端穿孔。延迟植入可膨胀阴茎假体由于可能出现广泛的海绵体纤维化而带来手术挑战。比较分析表明，与早期植入的患者相比，接受延迟植入可膨胀阴茎假体的缺血性阴茎异常勃起患者的并发症发生率更高。在报告并发症发生率的研究中，早期组的总并发症发生率为3.37%，显著低于延迟组（37.23%）。大多数研究支持缺血性阴茎异常勃起后早期植入可膨胀阴茎假体优于延迟植入。然而，需要进一步的研究来就假体植入时机达成全球共识。
