Presentation and Surgical Management of Ischemic Priapism: A 5-Year Review

Abstract

Objectives: To review the clinical presentation and surgical interventions carried out on patients with ischemic priapism at a tertiary health facility in north central Nigeria. Patients and Methods: Seventeen patients (median age 17 years, range 4-37) who were managed surgically and reviewed over a 5 year period. All patients had undergone distal shunt procedures and the outcomes on erectile function were examined in those who were sexually active.

Results: Most of the patients presented after 24 hours or more (>24 hours) following the onset of priapism. Sickle Cell Disease constituted 85% of all cases and we noted a bimodal age pattern amongst them (<12 years and >18 years). Intermittent penile massaging was employed after the shunt procedure to maintain detumescense in 12 patients after 24 hours of surgery. Twenty-five percent and 37% of sexually active patients maintained normal and partial erectile function respectively after surgical intervention regardless of delay in presentation.

Conclusion: This review highlights the fact that late and delayed presentation of priapism is still common in our environment and sickle cell disease remains a major predisposition. Appropriate surgical intervention using shunt procedures no matter how late, has the potential to preserve erectile function in some patients.