Penile Shunt / Aspiration

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, ie Ice-packs, Pseudo-ephedrine tablets etc.

Pre-requirements

• An informed consent is required from the patient.
• The risk of permanent Erectile Dysfunction should be discussed.
• This is done under a general anaesthetic. Patients may not eat or drink from midnight the previous evening.
• Patients are to refrain from smoking before the procedure.
• Patients allergic to IODINE / CHLORHEXIDINE should clearly state this at the Pre-admission clinic as well as to theatre staff and Dr Schoeman.

How is it done?

• This procedure is done under general anaesthetic.
• 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.
• If the Priapism is deflated, the procedure is completed by placing an Indwelling Catheter and an elasticated compression bandage for a few hours.
• Should the priapism persist, a short-circuit is with the Corpora spongiosum is created therefore creating a drainage of the blood.
• This may however also cause future erectile dysfunction.
• Select cases may require more invasive short-circuit devations of circulation

What to expect after the procedure?

• Any anaesthetic has its risks and the anaesthetist 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.
• Sick leave will be granted for a few weeks.
• Please direct all further queries to Dr Schoeman’s rooms.
• PLEASE CONTACT THE HOSPITAL DIRECT 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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Penile Shunt / Aspiration