Penile Shunt / Aspiration
Treatment of a low-flow priapism.
Why is it done?
- Prolonged painful erections lasting > 4-6 hours.
- Usually associated with drug use.
- Usually associated with intracavernosal administration of Erectile Dysfunction drugs.
- You would have conservative measures, i.e. Icepacks, Pseudo-ephedrine tablets etc.
How is it done?
- This procedure is done under general anesthetic.
- Supine position.
- The penis is surgically prepared.
- 2 large-bore cannulas are placed through the glans penis into the Corpora Cavernosa.
- Old clotted blood is drained until flaccid.
- The corpora is rinsed with saline.
- A weak mixture of Ephedrine may also be used to rinse the Corpora Cavernosa.
- Should this not be effective, a scalpel can be placed to cut the CC to create a short circuit with the CS.
- This may have erectile dysfunction as a result.
- If the priapism is deflated, the procedure is completed by placing an Indwelling Catheter and an elasticated compression bandage for a few hours.
What to expect after the procedure?
- Any anesthetic has its risks, and the anesthetist will explain such risks.
- Bleeding is a possible complication.
- Your catheter will be removed on Day 2-3.
- Recurrent priapism requiring more than 1 intervention.
- The possibility of permanent Erectile Dysfunction.
What next?
- Dressings should be kept dry for the initial 72 hours after surgery and soaked off in a bath thereafter.
- The catheter will be removed after 3 days.
- Patients should schedule a follow-up appointment with Dr Schoeman 4-6 weeks after the procedure.
- An arteriogram may be recommended to exclude AV-Fistulas.
- There will be signs of bruising for at least 10 days.
- PLEASE CONTACT THE HOSPITAL DIRECTLY WITH ANY POST-OPERATIVE CONCERNS AND RETURN TO THE HOSPITAL IMMEDIATELY SHOULD THERE BE ANY SIGNS OF SEPSIS and RETURN OF PRIAPISM.
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