AB227. Our experience of T-shaped shunt for the treatment of ischemic priapism

Objective: To explore the efficacy of T-shaped shunt operation for the treatment of ischemic priapism.

Methods: We retrospectively studied nine patients with ischemic priapism. All patients were given preoperative MRI examination, T-shaped shunt operation and heparin saline flushing were performed when conservative therapy failed, a wedge biopsy of corpus cavernosum were done during the operation for tissue diagnosis.

Results: All patients had satisfactory outcome of the T-shaped shunt surgery except two patients who were diagnosed as malignant priapism, one was due to perineal neuroendocrine carcinoma and he refused taking further therapy and died 3 months later; the other was caused by penile epithelioid sarcoma and then accepted partial resection of penis; during 6–12 months follow-up, five cases developed erectile dysfunction.

Conclusions: MRI appears to be valuable for the management of ischemic priapism. Although T-shaped shunt operation has advantages of simple operation, less complications and satisfactory efficacy, it is not suitable for the patient of ischemic priapism which is caused by tumor. A wedge biopsy of corpus cavernosum during operation is helpful to confirm malignant priapism.

Keywords: Ischemic priapism; MRI; T-shaped shunt; penile epithelioid sarcoma