A Systematic Review on Ischemic Priapism and Immediate Implantation: Do We Need More Data?

Marco Capece, Roberto La Rocca, Vincenzo Mirone, Trinity Bivalacqua, Fabio Castiglione, Maarten Albersen, David J. Ralph, Asif Muneer, Giulio Garaffa

Research output: Contribution to journalReview article

Abstract

Introduction: Ischemic priapism (IP) is the most common form of priapism. In cases of priapism persisting for >36 hours, conservative management usually fails, and the patients’ erectile tissue will be inevitably compromised, resulting in corporal fibrosis, shortening of the penis, and refractory erectile dysfunction. In this subset of patients, early implantation of a penile prosthesis (PP) could be a solution for both the priapic episode and the erectile dysfunction. Aim: To analyze the current literature with regard to the correlation between refractory ischemic priapism and immediate implantation of PP. Methods: An extensive literature research was conducted to retrieve studies focusing on immediate PP implantation in patients suffering from refractory ischemic priapism (RIP). Main Outcome Measures: We evaluated the functional outcomes of patients who have undergone the immediate insertion of a PP as treatment for an acute episode of IP refractory to medical therapy or shunt surgery. Results: Nine studies were included in this systematic review, including 3 case reports and 6 retrospective analyses. All studies agreed that in patients with RIP, early insertion of a PP is a safe and effective procedure, and all studies but 1 preferred malleable implants to inflatable implants. Conclusion: The systematic review does not demonstrate superiority of immediatePP implantation over delayed PP implantation, because none of the studies was designed with this purpose. However, considering the reduced complication rate and the ease of the procedure, all studies are in favor of early implantation over delayed implantation. Capece M, La Rocca R, Mirone V, et al. A Systematic Review on Ischemic Priapism and Immediate Implantation: Do We Need More Data? Sex Med Rev 2018;X:XXX–XXX.

Original languageEnglish (US)
JournalSexual Medicine Reviews
DOIs
StatePublished - Jan 1 2019

Fingerprint

Priapism
Penile Implantation
Penile Prosthesis
Erectile Dysfunction
Penis
Fibrosis
Outcome Assessment (Health Care)

Keywords

  • Early Implantation
  • Immediate Implant
  • Low-Flow Priapism
  • Penile Prosthesis
  • Priapism
  • Refractory Ischemic Priapism

ASJC Scopus subject areas

  • Reproductive Medicine
  • Dermatology
  • Obstetrics and Gynecology
  • Urology

Cite this

A Systematic Review on Ischemic Priapism and Immediate Implantation : Do We Need More Data? / Capece, Marco; La Rocca, Roberto; Mirone, Vincenzo; Bivalacqua, Trinity; Castiglione, Fabio; Albersen, Maarten; Ralph, David J.; Muneer, Asif; Garaffa, Giulio.

In: Sexual Medicine Reviews, 01.01.2019.

Research output: Contribution to journalReview article

Capece, Marco ; La Rocca, Roberto ; Mirone, Vincenzo ; Bivalacqua, Trinity ; Castiglione, Fabio ; Albersen, Maarten ; Ralph, David J. ; Muneer, Asif ; Garaffa, Giulio. / A Systematic Review on Ischemic Priapism and Immediate Implantation : Do We Need More Data?. In: Sexual Medicine Reviews. 2019.
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title = "A Systematic Review on Ischemic Priapism and Immediate Implantation: Do We Need More Data?",
abstract = "Introduction: Ischemic priapism (IP) is the most common form of priapism. In cases of priapism persisting for >36 hours, conservative management usually fails, and the patients’ erectile tissue will be inevitably compromised, resulting in corporal fibrosis, shortening of the penis, and refractory erectile dysfunction. In this subset of patients, early implantation of a penile prosthesis (PP) could be a solution for both the priapic episode and the erectile dysfunction. Aim: To analyze the current literature with regard to the correlation between refractory ischemic priapism and immediate implantation of PP. Methods: An extensive literature research was conducted to retrieve studies focusing on immediate PP implantation in patients suffering from refractory ischemic priapism (RIP). Main Outcome Measures: We evaluated the functional outcomes of patients who have undergone the immediate insertion of a PP as treatment for an acute episode of IP refractory to medical therapy or shunt surgery. Results: Nine studies were included in this systematic review, including 3 case reports and 6 retrospective analyses. All studies agreed that in patients with RIP, early insertion of a PP is a safe and effective procedure, and all studies but 1 preferred malleable implants to inflatable implants. Conclusion: The systematic review does not demonstrate superiority of immediatePP implantation over delayed PP implantation, because none of the studies was designed with this purpose. However, considering the reduced complication rate and the ease of the procedure, all studies are in favor of early implantation over delayed implantation. Capece M, La Rocca R, Mirone V, et al. A Systematic Review on Ischemic Priapism and Immediate Implantation: Do We Need More Data? Sex Med Rev 2018;X:XXX–XXX.",
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author = "Marco Capece and {La Rocca}, Roberto and Vincenzo Mirone and Trinity Bivalacqua and Fabio Castiglione and Maarten Albersen and Ralph, {David J.} and Asif Muneer and Giulio Garaffa",
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AU - La Rocca, Roberto

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AU - Castiglione, Fabio

AU - Albersen, Maarten

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N2 - Introduction: Ischemic priapism (IP) is the most common form of priapism. In cases of priapism persisting for >36 hours, conservative management usually fails, and the patients’ erectile tissue will be inevitably compromised, resulting in corporal fibrosis, shortening of the penis, and refractory erectile dysfunction. In this subset of patients, early implantation of a penile prosthesis (PP) could be a solution for both the priapic episode and the erectile dysfunction. Aim: To analyze the current literature with regard to the correlation between refractory ischemic priapism and immediate implantation of PP. Methods: An extensive literature research was conducted to retrieve studies focusing on immediate PP implantation in patients suffering from refractory ischemic priapism (RIP). Main Outcome Measures: We evaluated the functional outcomes of patients who have undergone the immediate insertion of a PP as treatment for an acute episode of IP refractory to medical therapy or shunt surgery. Results: Nine studies were included in this systematic review, including 3 case reports and 6 retrospective analyses. All studies agreed that in patients with RIP, early insertion of a PP is a safe and effective procedure, and all studies but 1 preferred malleable implants to inflatable implants. Conclusion: The systematic review does not demonstrate superiority of immediatePP implantation over delayed PP implantation, because none of the studies was designed with this purpose. However, considering the reduced complication rate and the ease of the procedure, all studies are in favor of early implantation over delayed implantation. Capece M, La Rocca R, Mirone V, et al. A Systematic Review on Ischemic Priapism and Immediate Implantation: Do We Need More Data? Sex Med Rev 2018;X:XXX–XXX.

AB - Introduction: Ischemic priapism (IP) is the most common form of priapism. In cases of priapism persisting for >36 hours, conservative management usually fails, and the patients’ erectile tissue will be inevitably compromised, resulting in corporal fibrosis, shortening of the penis, and refractory erectile dysfunction. In this subset of patients, early implantation of a penile prosthesis (PP) could be a solution for both the priapic episode and the erectile dysfunction. Aim: To analyze the current literature with regard to the correlation between refractory ischemic priapism and immediate implantation of PP. Methods: An extensive literature research was conducted to retrieve studies focusing on immediate PP implantation in patients suffering from refractory ischemic priapism (RIP). Main Outcome Measures: We evaluated the functional outcomes of patients who have undergone the immediate insertion of a PP as treatment for an acute episode of IP refractory to medical therapy or shunt surgery. Results: Nine studies were included in this systematic review, including 3 case reports and 6 retrospective analyses. All studies agreed that in patients with RIP, early insertion of a PP is a safe and effective procedure, and all studies but 1 preferred malleable implants to inflatable implants. Conclusion: The systematic review does not demonstrate superiority of immediatePP implantation over delayed PP implantation, because none of the studies was designed with this purpose. However, considering the reduced complication rate and the ease of the procedure, all studies are in favor of early implantation over delayed implantation. Capece M, La Rocca R, Mirone V, et al. A Systematic Review on Ischemic Priapism and Immediate Implantation: Do We Need More Data? Sex Med Rev 2018;X:XXX–XXX.

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