Priapsim: evaluation of treatment with special reference to saphenocavernous shunting in 26 patients.

In the past, idiopathic priapism was not treated at all or was conservatively managed by measures including aspiration and irrigation of the corpora cavernosa. Restoration of erectile function rarely resulted. Various venous bypass procedures have been tried since Grayhack, McCullough, O'Connor & Trippel in 1964 described the technique of saphenocavernous shunting in idiopathic priapism. Over a ten-year period 31 instances of priapism were seen in 30 patients. In 26 cases the priapism was classified as idiopathic. Saphenocavernous shunting was done in these 26 patients. At follow-up seven of them were potent. Our data indicate that alcoholism may be an aetiologic factor in idiopathic priapism, since 15 of the 26 men had a history of massive alcohol consumption. Idiopathic priapism should be regarded as a surgical emergency, and a venous shunt should be performed.