Corporal burnett "snake" surgical maneuver for the treatment of ischemic priapism: Long-term followup

Robert L. Segal, Nathaniel Readal, Phillip Martin Pierorazio, Arthur Burnett, Trinity Bivalacqua

Research output: Contribution to journalArticle

Abstract

Purpose: We provide long-term followup on a modification of the Al-Ghorab distal penile corporoglanular shunt surgery for the treatment of ischemic priapism. Materials and Methods: We conducted a retrospective review of patients surgically treated for ischemic priapism at The Johns Hopkins Hospital from January 2008 to April 2012 with the Burnett "Snake" maneuver of the Al-Ghorab shunt. Electronic medical records were reviewed to collect demographic information and telephone followup was performed to verify treatment outcomes. Patients completed the SHIM (Sexual Health Inventory for Men) to assess current erectile function. Results: A total of 10 patients were analyzed (age range 31 to 59 years). Mean followup was 6.7 months (range 0.5 to 17). Priapism etiologies were idiopathic (3), trazodone (2), trazodone and cocaine (3), intracavernous injection of trimix (1) and spinal cord injury (1). There were 6 patients who had previously undergone unsuccessful surgical attempts at priapism decompression and mean priapism duration was 75 hours (range 24 to 288). Of the 10 men 8 achieved successful resolution of priapism with no recurrence. There were 2 men with recurrent priapism refractory to all management who were definitively treated with insertion of an inflatable penile prosthesis. Of 9 men 6 had normal erectile function preoperatively, of whom 2 achieved at least partial erectile function postoperatively. Complications were sustained by 2 men, including wound infection with skin necrosis in 1, and an intraoperative urethral injury in the other with subsequent urethrocutaneous fistula formation and wound infection with skin necrosis. Conclusions: The modified Al-Ghorab corporoglanular shunt using the Burnett snake maneuver is successful in resolving ischemic priapism, particularly in cases refractory to first line management, and in preventing further episodes of priapism.

Original languageEnglish (US)
Pages (from-to)1025-1029
Number of pages5
JournalJournal of Urology
Volume189
Issue number3
DOIs
StatePublished - Mar 2013

Fingerprint

Priapism
Snakes
Trazodone
Therapeutics
Wound Infection
Necrosis
Penile Prosthesis
Skin
Electronic Health Records
Reproductive Health
Decompression
Spinal Cord Injuries
Cocaine
Telephone
Fistula
Demography
Recurrence
Equipment and Supplies
Injections

Keywords

  • erectile dysfunction
  • fibrosis
  • penile erection

ASJC Scopus subject areas

  • Urology

Cite this

Corporal burnett "snake" surgical maneuver for the treatment of ischemic priapism : Long-term followup. / Segal, Robert L.; Readal, Nathaniel; Pierorazio, Phillip Martin; Burnett, Arthur; Bivalacqua, Trinity.

In: Journal of Urology, Vol. 189, No. 3, 03.2013, p. 1025-1029.

Research output: Contribution to journalArticle

@article{e758daa871844298980e19c7d875f56b,
title = "Corporal burnett {"}snake{"} surgical maneuver for the treatment of ischemic priapism: Long-term followup",
abstract = "Purpose: We provide long-term followup on a modification of the Al-Ghorab distal penile corporoglanular shunt surgery for the treatment of ischemic priapism. Materials and Methods: We conducted a retrospective review of patients surgically treated for ischemic priapism at The Johns Hopkins Hospital from January 2008 to April 2012 with the Burnett {"}Snake{"} maneuver of the Al-Ghorab shunt. Electronic medical records were reviewed to collect demographic information and telephone followup was performed to verify treatment outcomes. Patients completed the SHIM (Sexual Health Inventory for Men) to assess current erectile function. Results: A total of 10 patients were analyzed (age range 31 to 59 years). Mean followup was 6.7 months (range 0.5 to 17). Priapism etiologies were idiopathic (3), trazodone (2), trazodone and cocaine (3), intracavernous injection of trimix (1) and spinal cord injury (1). There were 6 patients who had previously undergone unsuccessful surgical attempts at priapism decompression and mean priapism duration was 75 hours (range 24 to 288). Of the 10 men 8 achieved successful resolution of priapism with no recurrence. There were 2 men with recurrent priapism refractory to all management who were definitively treated with insertion of an inflatable penile prosthesis. Of 9 men 6 had normal erectile function preoperatively, of whom 2 achieved at least partial erectile function postoperatively. Complications were sustained by 2 men, including wound infection with skin necrosis in 1, and an intraoperative urethral injury in the other with subsequent urethrocutaneous fistula formation and wound infection with skin necrosis. Conclusions: The modified Al-Ghorab corporoglanular shunt using the Burnett snake maneuver is successful in resolving ischemic priapism, particularly in cases refractory to first line management, and in preventing further episodes of priapism.",
keywords = "erectile dysfunction, fibrosis, penile erection",
author = "Segal, {Robert L.} and Nathaniel Readal and Pierorazio, {Phillip Martin} and Arthur Burnett and Trinity Bivalacqua",
year = "2013",
month = "3",
doi = "10.1016/j.juro.2012.08.245",
language = "English (US)",
volume = "189",
pages = "1025--1029",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Corporal burnett "snake" surgical maneuver for the treatment of ischemic priapism

T2 - Long-term followup

AU - Segal, Robert L.

AU - Readal, Nathaniel

AU - Pierorazio, Phillip Martin

AU - Burnett, Arthur

AU - Bivalacqua, Trinity

PY - 2013/3

Y1 - 2013/3

N2 - Purpose: We provide long-term followup on a modification of the Al-Ghorab distal penile corporoglanular shunt surgery for the treatment of ischemic priapism. Materials and Methods: We conducted a retrospective review of patients surgically treated for ischemic priapism at The Johns Hopkins Hospital from January 2008 to April 2012 with the Burnett "Snake" maneuver of the Al-Ghorab shunt. Electronic medical records were reviewed to collect demographic information and telephone followup was performed to verify treatment outcomes. Patients completed the SHIM (Sexual Health Inventory for Men) to assess current erectile function. Results: A total of 10 patients were analyzed (age range 31 to 59 years). Mean followup was 6.7 months (range 0.5 to 17). Priapism etiologies were idiopathic (3), trazodone (2), trazodone and cocaine (3), intracavernous injection of trimix (1) and spinal cord injury (1). There were 6 patients who had previously undergone unsuccessful surgical attempts at priapism decompression and mean priapism duration was 75 hours (range 24 to 288). Of the 10 men 8 achieved successful resolution of priapism with no recurrence. There were 2 men with recurrent priapism refractory to all management who were definitively treated with insertion of an inflatable penile prosthesis. Of 9 men 6 had normal erectile function preoperatively, of whom 2 achieved at least partial erectile function postoperatively. Complications were sustained by 2 men, including wound infection with skin necrosis in 1, and an intraoperative urethral injury in the other with subsequent urethrocutaneous fistula formation and wound infection with skin necrosis. Conclusions: The modified Al-Ghorab corporoglanular shunt using the Burnett snake maneuver is successful in resolving ischemic priapism, particularly in cases refractory to first line management, and in preventing further episodes of priapism.

AB - Purpose: We provide long-term followup on a modification of the Al-Ghorab distal penile corporoglanular shunt surgery for the treatment of ischemic priapism. Materials and Methods: We conducted a retrospective review of patients surgically treated for ischemic priapism at The Johns Hopkins Hospital from January 2008 to April 2012 with the Burnett "Snake" maneuver of the Al-Ghorab shunt. Electronic medical records were reviewed to collect demographic information and telephone followup was performed to verify treatment outcomes. Patients completed the SHIM (Sexual Health Inventory for Men) to assess current erectile function. Results: A total of 10 patients were analyzed (age range 31 to 59 years). Mean followup was 6.7 months (range 0.5 to 17). Priapism etiologies were idiopathic (3), trazodone (2), trazodone and cocaine (3), intracavernous injection of trimix (1) and spinal cord injury (1). There were 6 patients who had previously undergone unsuccessful surgical attempts at priapism decompression and mean priapism duration was 75 hours (range 24 to 288). Of the 10 men 8 achieved successful resolution of priapism with no recurrence. There were 2 men with recurrent priapism refractory to all management who were definitively treated with insertion of an inflatable penile prosthesis. Of 9 men 6 had normal erectile function preoperatively, of whom 2 achieved at least partial erectile function postoperatively. Complications were sustained by 2 men, including wound infection with skin necrosis in 1, and an intraoperative urethral injury in the other with subsequent urethrocutaneous fistula formation and wound infection with skin necrosis. Conclusions: The modified Al-Ghorab corporoglanular shunt using the Burnett snake maneuver is successful in resolving ischemic priapism, particularly in cases refractory to first line management, and in preventing further episodes of priapism.

KW - erectile dysfunction

KW - fibrosis

KW - penile erection

UR - http://www.scopus.com/inward/record.url?scp=84873723132&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84873723132&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2012.08.245

DO - 10.1016/j.juro.2012.08.245

M3 - Article

C2 - 23017524

AN - SCOPUS:84873723132

VL - 189

SP - 1025

EP - 1029

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 3

ER -