Non-incisional therapy for priapism.

During a 4-year period 7 patients with priapism were managed successfully with a non-incision treatment program. Three were treated by hypotensive anesthesia with sodium nitroprusside, 2 by the Winter procedure (creating a temporary cavernospongiosum shunt) and 2 by combining hypotensive anesthesia and the Winter procedure. Causes of the priapism were pelvic infection in 1 patient, sickle cell trait in 2 and post-hemodialysis in 2. The cause was not known in 2 cases. Of the 7 patients 5 were potent before the onset of the priapism and remained so after treatment. No complications of therapy were noted and hospitalization averaged 1.4 days, with 5 patients being discharged the day after treatment. Our experience with these 7 patients indicates that creation of a vascular shunt by an operative technique may not be necessary to alleviate priapism.