Barry shunt for treatment of a 76-hour stuttering priapism without subsequent erectile dysfunction
Daniar Kurmanbekovich Osmonov, Aleksey Aksenov, Andrea Nathaly Guerra Sandoval, Almut Kalz, Klaus Peter Juenemann
Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
Introduction: This paper reports treatment of a 76-hour low-flow priapism with a shunting procedure that was first described by Barry in 1976. We were able to observe the preservation of erectile function despite the long period of ischemia. A review of the literature shows that there are few reports of erectile function recovery after a priapism of similar duration.
Materials and methods: A 42-year-old patient presented with a 76-hour priapism, probably caused by consumption of alcohol and illegal drugs. A Barry Shunt procedure was performed. The erectile function of the patient was assessed by means of International Index of Erectile Function score over a follow-up period of 30 months. Moreover, we reviewed different surgical options for treatment of priapism in the literature.
Results: Partial return of erection without sexual arousal occurred on two occasions during the 10-day hospitalization, but was treated by manipulation of the penis, ie, by milking the tumescence into the shunt. After 3 months, the shunt was still palpable as a subcutaneous swelling. Six months postoperatively, the residual swelling had disappeared. The International Index of Erectile Function score was of 21 without phosphodiesterase type 5 inhibitors after a follow-up of 2.5 years.
Conclusion: Barry shunt is an effective alternative surgical option for the treatment of low-flow priapism. In the case of our patient, it was also effective after a 76-hour-lasting priapism.
Keywords: low flow priapism, erectile function, cavernovenous shunt, surgical treatment of stuttering priapism
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