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J Sex Med. 2009 Apr;6(4):1171-6. doi: 10.1111/j.1743-6109.2008.01176.x. Epub 2009 Feb 4.

Corporal "snake" maneuver: corporoglanular shunt surgical modification for ischemic priapism.

Author information

  • 1Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD 21287-2411, USA. aburnett@jhmi.edu

Abstract

INTRODUCTION:

Current surgical shunting procedures for major ischemic priapism do not always effectively resolve acute presentations of this disorder.

AIM:

To evaluate a modification of the Al-Ghorab distal penile corporoglanular shunt surgery for ischemic priapism.

METHODS:

Three previously potent men (48, 43, 40 years of age) presented with major ischemic priapism episodes (5, 2, and 6 days in duration, respectively), which were refractory to clinical management including sympathomimetic intracavernosal treatments, intracorporal aspiration and saline irrigation, and penile shunt surgery attempts. We offered a surgical technique for facilitating corporal blood evacuation by retrograde insertion of a cavernosal dilator through the excised tunical windows of the distal corpora cavernosa after transglanular incision.

MAIN OUTCOME MEASURES:

Clinical evaluation of priapism resolution and erection recovery.

RESULTS:

All men achieved successful resolution of priapism, with meaningful erection recovery assessable in one man. Conclusions. The modified Al-Ghorab corporoglanular shunt surgery appears to offer an advantageous management approach to resolve ischemic priapism, particularly for cases refractory to first-line management.

Comment in

PMID:
19207268
[PubMed - indexed for MEDLINE]
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