Journal of Andrology
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Published-Ahead-of-Print May 13, 2010, DOI:10.2164/jandrol.110.010132

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Al-Ghorab Shunt Plus Intracavernous Tunneling for Prolonged Ischemic Priapism

Wenqing Lian , Jinxing Lv , Wanshou Cui , Zhe Jin , Tao Liu , Weiren Li , Yiming Yuan , and Zhong-cheng Xin *

* To whom correspondence should be addressed. E-mail: xinzc{at}bjmu.edu.cn.

Our objective was to investigate the efficacy and safety of corpus cavernosum-corpus spongiosum shunt (Al-Ghorab Shunt) plus intracavernous tunneling (CC-CSS+ICT) for prolonged ischemic priapism (PIP). Twelve patients with PIP were enrolled in this study. The mean age of patients was 38.3 ± 9.2 years old and the mean duration of PIP was 2.8 ± 1.0 days (range from 1.5 to 4 days). All patients were performed CC-CSS+ICT for treating PIP. The penile hardness score (PHS) and pain visual analogue score (PVAS) were used to assess the efficacy of the surgery post 1, 3, 5 days respectively. Color Duplex Doppler Ultrasonography (CDDU), International Index of Erectile Function (IIEF5) and quality of life (QOL) were used for evaluating penile morphology, erectile function, quality of life and response to Sildenafil treatment. The mean duration of follow up was 21.6 ± 10.1 months. All of 12 cases successfully restored penile detumescence post surgery with the mean PHS and PVAS significantly decreased compared with that of pre surgery at different time point (post 1, 3, 5 days) (p<0.001). The cavernosal arterial blood flow were observed with the mean PSV at 1, 3, 5 days post operation were 17.79 ± 2.04, 19.14 ± 1.58, 7.73 ± 2.02 cm/s respectively. All patients suffered from CC fibrosis and ED post operation, only 2 cases (16.7%) with short duration of PIP (1.5 days) showed response to Sildenafil treatment, 3 cases(25.0%) with severe fibrosis were satisfied with sexual life after excision of penile corpus cavernosum scar and penile prosthesis implantation (PPI). The CC-CSS+ICT could quickly reduce penile rigidity and pain for improving the symptoms of PIP and suggested a safe and effective therapeutic method for PIP.


Key words: Erectile Dysfunction • corpus cavernosum-corpus spongiosum shunt • intracavernous tunneling • ischemic priapism






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