Treatment of ischemic priapism with Grayhack surgery - case report

  • Vítor Ferreira Serviço de Angiologia e Cirurgia Vascular - Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
  • Arlindo Matos Serviço de Angiologia e Cirurgia Vascular - Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
  • La Fuente Carvalho Serviço de Urologia - Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
  • Nuno Azevendo Serviço de Urologia - Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
  • Daniel Reis Serviço de Urologia - Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
  • Luís Loureiro Serviço de Angiologia e Cirurgia Vascular - Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
  • Tiago Loureiro Serviço de Angiologia e Cirurgia Vascular - Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
  • Lisa Borges Serviço de Angiologia e Cirurgia Vascular - Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
  • Diogo Silveira Serviço de Angiologia e Cirurgia Vascular - Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
  • Sérgio Teixeira Serviço de Angiologia e Cirurgia Vascular - Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
  • Duarte Rego Serviço de Angiologia e Cirurgia Vascular - Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
  • João Gonçalves Serviço de Angiologia e Cirurgia Vascular - Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
  • Gabriela Teixeira Serviço de Angiologia e Cirurgia Vascular - Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
  • Inês Antunes Serviço de Angiologia e Cirurgia Vascular - Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
  • Joana Martins Serviço de Angiologia e Cirurgia Vascular - Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal
  • Rui Almeida Serviço de Angiologia e Cirurgia Vascular - Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal

Abstract

Ischemic priapism is a persistent erection unrelated to sexual stimulation characterized by reduced or absent intracavernous blood flow. We present a clinical case of a 30 year old man with priapism with 48 hours of progression. He underwent surgical drainage of the corpora cavernosa, instillation of ephedrine, and creation of a cavernous-spongeous shunt without improvement. On the duplex ultrasound there was no flow in the cavernous arteries, thrombosis of the cavernous veins and normal dorsal venous flow. He underwent Grayhack surgery with creation of cavernous-femoral bypass with great saphenous vein bilaterally. He underwent a Grayhack surgery with creation of a bilateral cavernous-femoral bypass with great saphenous vein. There was clinical improvement and resolution of the priapism. On the 7th post-operative day, it was documented thrombosis of the bypasses and patent cavernous arteries and veins.

References

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2. Song PH, Moon KH. Priapism: Current updates in clinical management. Korean J Urol. 2013 Dec;54:816-23.

3. Cherian J, Rao AR, Thwaini A, et al. Medical and surgical management of priapism. Postgrad Med J. 2006;82:89-94.

4. Tabibi A, Abdi H, Mahmoudnejad N. Erectile function and dysfunction following low flow priapism: A comparison of distal and proximal shunts. Urol J. 2010 Summer;7:174-7.

5. Montague DK, Jarow J, Broderick GA. et al. American Urological Association guideline on the management of priapism. J Urol. 20031701318-1325.1325.

6. Munarriz R, Wen CC, McAuley I, et al. Management of ischemic priapism with high-dose intracavernosal phenylephrine: From bench to bedside. J Sex Med. 2006;3:918-22.

7. Grayhack JT, Mccullough W, O’Conor VJ, et al. Venous bypass to control priapism. Invest Urol. 1964;1:509---13.
Published
2016-12-16
How to Cite
FERREIRA, Vítor et al. Treatment of ischemic priapism with Grayhack surgery - case report. Angiologia e Cirurgia Vascular, [S.l.], v. 12, n. 3, p. 211-213, dec. 2016. ISSN 2183-0096. Available at: <http://acvjournal.com/index.php/acv/article/view/10>. Date accessed: 16 dec. 2017.
Section
Clinical Case

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