[VP-034]T-Shunt Surgery in Resistant Priapism TherapyKamil Gökhan Şeker, Yunus Çolakoğlu, Yusuf Arıkan, Mithat Ekşi, Emre Şam, Ramazan Uğur, Mustafa Gürkan Yenice, Abdulmuttalip Şimşek, Volkan TuğcuIntroduction Priapism is a urological emergency that requires more than 4 hours of penile erection without sexual stimulation or sexual intercourse and that must be treated immediately. Case A 47-year-old male patient who had undergone hemodialysis in the last two months applied to the emergency department due to ongoing priapism for 12 hours. There was no trauma story, sickle cell anemia, illegal drug use, nitrate use, sexual intercourse, no psychostimulant use, vasoactive substance or phosphodiesterase inhibitors in the patient's history. Blood gases from corpus cavernosum were pH 7.3, pCO2: 49.1 mmHg, pO2: 51 mmHg. The patient was diagnosed with ischemic priapism. The patient then underwent an unsuccessful conservative treatment with multiple corpus aspiration with a 16 G butterfly needle. Intracavernosal phenylephrine injection was performed with a patient undergoing local anesthesia (penile block) (corporate aspiration was tried 2 times at 30 minute intervals). Despite the removal of venous blood at approximately 150 cc, no detumescence could be obtained within 30 minutes. Then the operation decision was taken. T-shunt combined with corporate tunnel was performed. Conclusion The necessity of using proximal and distal shunt techniques in cases where medical treatment, which is a combination of aspiration and sympathomimetic agents in priapism, is unsuccessful should be kept in mind. |