Anatomic and Functional Outcome Following Distal Shunt and Tunneling for Treatment Ischemic Priapism: A Single-Center Experience

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dc.authoridERMEÇ, BAHADIR/0000-0002-7680-9119
dc.authoridÇevik, Gökhan/0000-0001-5221-5132
dc.authoridortac, mazhar/0000-0002-4784-5209
dc.authorwosidERMEÇ, BAHADIR/AAL-5061-2021
dc.authorwosidKadioglu, Ates/AAV-6720-2020
dc.authorwosidÇevik, Gökhan/GZA-3993-2022
dc.contributor.authorOrtac, Mazhar
dc.contributor.authorCevik, Gokhan
dc.contributor.authorAkdere, Hakan
dc.contributor.authorErmec, Bahadir
dc.contributor.authorKadioglu, Ates
dc.date.accessioned2024-06-12T11:07:06Z
dc.date.available2024-06-12T11:07:06Z
dc.date.issued2019
dc.departmentTrakya Üniversitesien_US
dc.description.abstractBackground: Ischemic priapism (IP) is a urologic emergency that requires early intervention. The main aim of IP treatment is to relieve the cavernosal pressure and provide erectile function. Aim: The aim of this study was to determine the correlation between preoperative risk factors (patient's age, duration of priapism, preoperative erectile function) and postoperative erectile dysfunction (ED). Methods: This retrospective study consisted of 25 patients diagnosed with refractory IP between 2009-2017. The diagnosis of IP was confirmed by medical history, physical examination, and cavernosal blood gas analysis. All of the patients underwent the T-shunt procedure +/- tunneling after a failed initial intervention. Results: The mean age at the time of the IP diagnosis was 46.84 years (range 23-77). The average follow-up time of the study population was 40.4 months (range 3-114), and the median time from the occurrence of IP to surgery was 58 hours (range 24-240). In all cases, rapid resolution of the erection was achieved with the T-shunt +/- tunneling procedure. In 1 patient, priapism recurred after 12 hours. Postoperative ED was reported by 16 (84.21%) patients, with degrees of mild, mild to moderate, and severe in 6, 1, and 9 of these cases, respectively. During the follow-up, the mean International Index of Erectile Function-5 (IIEF-5) score was 12.68 (range 5-23). Only 3 (15.78%) patients achieved successful sexual intercourse without any treatment. 6 (31.5%) patients required the aid of phosphodiesterase type 5 inhibitors, and 1 (5.26%) patient required the aid of a vacuum erection device. The 9 (47.36%) patients with severe ED failed to respond to medical treatment and were considered candidates for a penile implant. According to Kendall's tau-b correlation coefficient analysis, there was a positive correlation between the preoperative and postoperative IIEF-5 scores (P = .005), whereas the patient's age and duration of priapism were negatively correlated with the postoperative IIEF-5 score (P = .016 and P = .046, respectively). Clinical Implications: Treatment options of IP should be discussed with patients in terms of both preoperative erectile function and the duration of priapism. Strengths & Limitations: The small sample size and retrospective nature of this study were the main limitations. Conclusions: Despite high success and low complication rates of T-shunt surgery, the rate of undisturbed erectile function is only 14.6%. The patient's age, the existence of preoperative ED, and the duration of priapism are associated with postoperative IIEF-5 scores. Copyright (C) 2019, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.en_US
dc.identifier.doi10.1016/j.jsxm.2019.05.011
dc.identifier.endpage1296en_US
dc.identifier.issn1743-6095
dc.identifier.issn1743-6109
dc.identifier.issue8en_US
dc.identifier.pmid31230939en_US
dc.identifier.scopus2-s2.0-85067426262en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage1290en_US
dc.identifier.urihttps://doi.org/10.1016/j.jsxm.2019.05.011
dc.identifier.urihttps://hdl.handle.net/20.500.14551/21897
dc.identifier.volume16en_US
dc.identifier.wosWOS:000477706800019en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Sci Ltden_US
dc.relation.ispartofJournal Of Sexual Medicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectIschemic Priapismen_US
dc.subjectErectile Functionen_US
dc.subjectRisk Factorsen_US
dc.subjectT-Shunt Surgeryen_US
dc.subjectInternational Indexen_US
dc.subjectSnake Maneuveren_US
dc.subjectManagementen_US
dc.subjectEfficacyen_US
dc.subjectSurgeryen_US
dc.subjectVersionen_US
dc.titleAnatomic and Functional Outcome Following Distal Shunt and Tunneling for Treatment Ischemic Priapism: A Single-Center Experienceen_US
dc.typeReview Articleen_US

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