{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T18:59:53Z","timestamp":1770490793692,"version":"3.49.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T00:00:00Z","timestamp":1560988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T00:00:00Z","timestamp":1560988800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Ischemic priapism (IP) is a urologic emergency that requires early intervention. The main aim of IP treatment is to relieve the cavernosal pressure and provide erectile function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>The aim of this study was to determine the correlation between preoperative risk factors (patient\u2019s age, duration of priapism, preoperative erectile function) and postoperative erectile dysfunction (ED).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective study consisted of 25 patients diagnosed with refractory IP between 2009\u20132017. The diagnosis of IP was confirmed by medical history, physical examination, and cavernosal blood gas analysis. All of the patients underwent the T-shunt procedure \u00b1 tunneling after a failed initial intervention.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The mean age at the time of the IP diagnosis was 46.84 years (range 23\u201377). The average follow-up time of the study population was 40.4 months (range 3\u2013114), and the median time from the occurrence of IP to surgery was 58 hours (range 24\u2013240). In all cases, rapid resolution of the erection was achieved with the T-shunt \u00b1 tunneling procedure. In 1 patient, priapism recurred after 12 hours. Postoperative ED was reported by 16 (84.21%) patients, with degrees of mild, mild to moderate, and severe in 6, 1, and 9 of these cases, respectively. During the follow-up, the mean International Index of Erectile Function\u20135 (IIEF-5) score was 12.68 (range 5\u201323). Only 3 (15.78%) patients achieved successful sexual intercourse without any treatment. 6 (31.5%) patients required the aid of phosphodiesterase type 5 inhibitors, and 1 (5.26%) patient required the aid of a vacuum erection device. The 9 (47.36%) patients with severe ED failed to respond to medical treatment and were considered candidates for a penile implant. According to Kendall\u2019s tau-b correlation coefficient analysis, there was a positive correlation between the preoperative and postoperative IIEF-5 scores (P\u00a0= .005), whereas the patient\u2019s age and duration of priapism were negatively correlated with the postoperative IIEF-5 score (P\u00a0= .016 and P\u00a0= .046, respectively).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>Treatment options of IP should be discussed with patients in terms of both preoperative erectile function and the duration of priapism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths &amp; Limitations<\/jats:title>\n                  <jats:p>The small sample size and retrospective nature of this study were the main limitations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Despite high success and low complication rates of T-shunt surgery, the rate of undisturbed erectile function is only 14.6%. The patient\u2019s age, the existence of preoperative ED, and the duration of priapism are associated with postoperative IIEF-5 scores.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2019.05.011","type":"journal-article","created":{"date-parts":[[2019,6,21]],"date-time":"2019-06-21T09:44:43Z","timestamp":1561110283000},"page":"1290-1296","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":21,"title":["Anatomic and Functional Outcome Following Distal Shunt and Tunneling for Treatment \u0130schemic Priapism: A Single-Center Experience"],"prefix":"10.1093","volume":"16","author":[{"given":"Mazhar","family":"Orta\u00e7","sequence":"first","affiliation":[{"name":"Department of Urology , Istanbul \u00a0 Turkey"},{"name":"Istanbul Faculty of Medicine , Istanbul \u00a0 Turkey"},{"name":"Istanbul University , Istanbul \u00a0 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Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}