Role of Penile Prosthesis Insertion in the Treatment of Acute Priapism

Ischemic priapism must be expeditiously treated to prevent corporal fibrosis, penile shortening, and erectile dysfunction. Medical therapy with corporal aspiration and irrigation is a useful first-line therapy, but in refractory cases, invasive procedures are typically necessary. Though sometimes effective, shunt surgeries are not universally successful in achieving detumescence and exacerbate corporal scarring, which makes subsequent penile prosthesis insertion more difficult. Insertion of a penile prosthesis during an acute episode of refractory, ischemic priapism alleviates pain and allows the patient to resume sexual function earlier. It also obviates the corporal scarring that may significantly shorten the penis and complicate subsequent prosthesis insertion.