Turkish Journal of Urology
ANDROLOGY - Case Report

High-flow priapism after T-shunt and tunneling in a patient with ischemic priapism


Urology Unit, Policlinico S.Orsola-University Hospital, Bologna, Italy


Andrology Unit, Policlinico S.Orsola-University Hospital, Bologna, Italy


Radiology Unit, Policlinico S.Orsola-University Hospital, Bologna, Italy

Turk J Urol 2020; 46: 488-491
DOI: 10.5152/tud.2020.20144
Read: 92 Downloads: 45 Published: 21 September 2020

Priapism is defined as an erection lasting for more than 4 hours without sexual stimulation. It is grouped into 3 subtypes: ischemic (low-flow), nonischemic (high-flow), and stuttering priapism. Herein we describe a rare event of high-flow state as a result of conversion from a delayed ischemic priapism after a T-shunt with tunneling. To our knowledge, there is a paucity of reported cases, and the pathophysiology is still unclear. Clinicians should be aware of this uncommon but known scenario in case of penile tumescence after shunting procedure for ischemic priapism; penile Doppler ultrasound and selective pudendal angiography represent essential tools for diagnosis and treatment of this rare condition. In delayed ischemic priapism persisting for >36 hours, patients should be counseled about the irreversible damages of the cavernosal muscle and erectile dysfunction to consider an early penile prosthesis implantation with a satisfactory long-term functional outcome, decreasing the risks related to a distal shunt procedure.

Cite this article as: Vagnoni V, Franceschelli A, Gentile G, Palmisano F, Renzulli M, Cappelli A, et al. Turk J Urol 2020; 46(6): 488-91.

ISSN 2149-3235 EISSN 2149-3057