{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T10:26:24Z","timestamp":1776421584702,"version":"3.51.2"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,3,19]],"date-time":"2019-03-19T00:00:00Z","timestamp":1552953600000},"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":[[2019,3,19]],"date-time":"2019-03-19T00:00:00Z","timestamp":1552953600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Current management of ischemic priapism revolves around 3 principles: resolving the acute event, preserving erectile function, and reducing the risk of future recurrences. Although more conservative management options, such as aspiration, irrigation, and surgical shunts, are effective in many patients, those who are refractory to these interventions or have prolonged priapism may benefit from placement of a penile prosthesis (PP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To provide a comprehensive overview of priapism management, highlight the current literature on the utility of penile implants for refractory priapism, and provide insight from a high-volume center on surgical decision making and technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A complete review of the current guidelines and associated literature was performed. Associated algorithms were evaluated, and our experience was overlaid on the data present in the literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>The current management algorithm for priapism was evaluated. Subsequently, the data on acute and delayed PP placement were assessed. Rates of postoperative infection, erectile dysfunction, and patient satisfaction were also examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, both delayed and early PP implants are associated with higher rates of failure than routine PP implants. In patients with refractory or prolonged priapism, early implantation may be technically easier, with decreased loss of penile length and associated complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients should be evaluated on an individual basis and counseled on the risks and benefits of PP implantation in early and delayed time frames. Although there is no definitive evidence at this time regarding the ideal device or timing of implantation, there are well-established pros and cons of malleable vs inflatable prostheses and of acute vs delayed implantation.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.sxmr.2019.01.001","type":"journal-article","created":{"date-parts":[[2019,3,19]],"date-time":"2019-03-19T14:34:35Z","timestamp":1553006075000},"page":"131-139","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":25,"title":["Management of Priapism: A Contemporary Review"],"prefix":"10.1093","volume":"8","author":[{"given":"Kirtishri","family":"Mishra","sequence":"first","affiliation":[{"name":"Urology Institute, University Hospitals Cleveland Medical Center , Cleveland , USA"},{"name":"Case Western Reserve University School of Medicine , Cleveland , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aram","family":"Loeb","sequence":"additional","affiliation":[{"name":"Urology Institute, University Hospitals Cleveland Medical Center , Cleveland , USA"},{"name":"Case Western Reserve University School of Medicine , Cleveland , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Bukavina","sequence":"additional","affiliation":[{"name":"Urology Institute, University Hospitals Cleveland Medical Center , Cleveland , USA"},{"name":"Case Western Reserve University School of Medicine , Cleveland , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Baumgarten","sequence":"additional","affiliation":[{"name":"Department of Urology, University of South Florida , Tampa , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Beilan","sequence":"additional","affiliation":[{"name":"Department of Urology, University of South Florida , Tampa , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Mendez","sequence":"additional","affiliation":[{"name":"Department of Urology, University of South Florida , Tampa , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"DiGiorgio","sequence":"additional","affiliation":[{"name":"Department of Urology, University of South Florida , Tampa , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liying","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tampa General Hospital , Tampa , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Carrion","sequence":"additional","affiliation":[{"name":"Department of Urology, University of South Florida , Tampa , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,3,19]]},"reference":[{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1016\/S0090-4295(01)00941-4","article-title":"Incidence of priapism in the general population","volume":"57","author":"Eland","year":"2001","journal-title":"Urology"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1097\/01.ju.0000087608.07371.ca","article-title":"American Urological Association guideline on the management of priapism","volume":"170","author":"Montague","year":"2003","journal-title":"J Urol"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1038\/aja.2012.83","article-title":"A pathophysiology-based approach to the management of early priapism","volume":"15","author":"Kovac","year":"2013","journal-title":"Asian J Androl"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"1880","DOI":"10.1111\/j.1743-6109.2011.02281.x","article-title":"Penile prosthesis surgery in patients with corporal fibrosis: A state of the art review","volume":"8","author":"Martinez-Salamanca","year":"2011","journal-title":"J Sex Med"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"46","DOI":"10.4103\/0974-7796.165717","article-title":"Outcome and erectile function following treatment of priapism: An institutional experience","volume":"8","author":"Pal","year":"2016","journal-title":"Urol Ann"},{"key":"2023041308055117700_","first-page":"46","article-title":"Drug-induced priapism. Its aetiology, incidence and treatment","volume":"4","author":"Banos","year":"1989","journal-title":"Med Toxicol Adverse Drug Exp"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.eururo.2013.11.008","article-title":"European Association of Urology guidelines on priapism","volume":"65","author":"Salonia","year":"2014","journal-title":"Eur Urol"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1159\/000050961","article-title":"Priapism associated with intracavernosal injection of cocaine","volume":"67","author":"Mireku-Boateng","year":"2001","journal-title":"Urol Int"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1177\/1756287214542096","article-title":"Management of priapism: An update for clinicians","volume":"6","author":"Levey","year":"2014","journal-title":"Ther Adv Urol"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.ijscr.2017.12.038","article-title":"Priapism as the initial sign in hematologic disease: Case report and literature review","volume":"43","author":"Becerra-Pedraza","year":"2018","journal-title":"Int J Surg Case Rep"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1038\/aja.2011.114","article-title":"Medical management of ischemic stuttering priapism: A contemporary review of the literature","volume":"14","author":"Levey","year":"2012","journal-title":"Asian J Androl"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1002\/med.21476","article-title":"Comprehensive review of cardiovascular toxicity of drugs and related agents","volume":"38","author":"Mladenka","year":"2018","journal-title":"Med Res Rev"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1016\/j.jsxm.2018.05.012","article-title":"The hemodynamic effects of intracavernosal phenylephrine for the treatment of ischemic priapism","volume":"15","author":"Sidhu","year":"2018","journal-title":"J Sex Med"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"394","DOI":"10.4111\/kju.2013.54.6.394","article-title":"Transient distal penile corporoglanular shunt as an adjunct to aspiration and irrigation procedures in the treatment of early ischemic priapism","volume":"54","author":"Canguven","year":"2013","journal-title":"Korean J Urol"},{"key":"2023041308055117700_","first-page":"9","article-title":"Pharmacologic erection: Time-dependent changes in the corporal environment","volume":"6","author":"Broderick","year":"1994","journal-title":"Int J Impot Res"},{"key":"2023041308055117700_","first-page":"61","article-title":"Commentary on refractory ischemic priapism","volume":"1","author":"Garcia","year":"2012","journal-title":"Trans Androl Urol"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1016\/j.urology.2005.11.001","article-title":"Corporeal excavation: New technique for penile prosthesis implantation in men with severe corporeal fibrosis","volume":"67","author":"Montague","year":"2006","journal-title":"Urology"},{"key":"2023041308055117700_","first-page":"316","article-title":"Should perioperative anticoagulation be an integral part of the priapism shunting procedure?","volume":"2","author":"Lue","year":"2013","journal-title":"Transl Androl Urol"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5152\/tud.2017.59458","article-title":"Ischaemic priapism: A clinical review","volume":"43","author":"Ridgley","year":"2017","journal-title":"Turk J Urol"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"258","DOI":"10.4081\/aiua.2015.3.258","article-title":"Distal corpus cavernosum fibrosis and erectile dysfunction secondary to non-ischaemic priapism","volume":"87","author":"Zacharakis","year":"2015","journal-title":"Arch Ital Urol Androl"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"4","DOI":"10.5534\/wjmh.17040","article-title":"Role of penile prosthesis in priapism: A review","volume":"36","author":"Reddy","year":"2018","journal-title":"World J Mens Health"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/j.eururo.2008.09.044","article-title":"The immediate insertion of a penile prosthesis for acute ischaemic priapism","volume":"56","author":"Ralph","year":"2009","journal-title":"Eur Urol"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0140-6736(12)60520-0","article-title":"Erectile dysfunction","volume":"381","author":"Shamloul","year":"2013","journal-title":"Lancet"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1111\/bju.12686","article-title":"Penile prosthesis insertion in patients with refractory ischaemic priapism: Early vs delayed implantation","volume":"114","author":"Zacharakis","year":"2014","journal-title":"BJU Int"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1016\/j.eururo.2006.10.026","article-title":"Penile length alterations following penile prosthesis surgery","volume":"51","author":"Deveci","year":"2007","journal-title":"Eur Urol"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/j.juro.2015.08.091","article-title":"The malleable implant salvage technique: infection outcomes after Mulcahy salvage procedure and replacement of infected inflatable penile prosthesis with malleable prosthesis","volume":"195","author":"Gross","year":"2016","journal-title":"J Urol"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1038\/ijir.2011.23","article-title":"Early insertion of inflatable prosthesis for intractable ischemic priapism: Our experience and review of the literature","volume":"23","author":"Sedigh","year":"2011","journal-title":"Int J Impot Res"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1046\/j.1464-410X.2002.03058.x","article-title":"The management of low-flow priapism with the immediate insertion of a penile prosthesis","volume":"90","author":"Rees","year":"2002","journal-title":"BJU Int"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1111\/jsm.12115","article-title":"Managing the difficult penile prosthesis patient","volume":"10","author":"Trost","year":"2013","journal-title":"J Sex Med"},{"issue":"Suppl 7","key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1111\/jsm.12985","article-title":"Critical appraisal and review of management strategies for severe fibrosis during penile implant surgery","volume":"12","author":"Trost","year":"2015","journal-title":"J Sex Med"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"S797","DOI":"10.21037\/tau.2017.04.26","article-title":"The use of penile prostheses in the management of priapism","volume":"6","author":"Moore","year":"2017","journal-title":"Transl Androl Urol"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s11934-015-0491-0","article-title":"Strategies for penile prosthesis placement in Peyronie's disease and corporal fibrosis","volume":"16","author":"Yafi","year":"2015","journal-title":"Curr Urol Rep"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"2300","DOI":"10.1016\/j.juro.2010.02.014","article-title":"Management of ischemic priapism by penile prosthesis insertion: Prevention of distal erosion","volume":"183","author":"Salem","year":"2010","journal-title":"J Urol"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1007\/s11930-016-0073-2","article-title":"Distal extrusion and impending cylinder erosion of the penile prosthesis: A clinical challenge for the urologist","volume":"8","author":"Sukhu","year":"2016","journal-title":"Curr Sex Health Rep"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1111\/jsm.12578","article-title":"The \"carrion cast\": An intracavernosal antimicrobial cast for the treatment of infected penile implant","volume":"11","author":"Martinez","year":"2014","journal-title":"J Sex Med"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.jsxm.2016.11.304","article-title":"Successful placement of penile prostheses in men with severe corporal fibrosis following vacuum therapy protocol","volume":"14","author":"Tsambarlis","year":"2017","journal-title":"J Sex Med"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"468","DOI":"10.3109\/21681805.2015.1059359","article-title":"Early insertion of a malleable penile prosthesis in ischaemic priapism allows later upsizing of the cylinders","volume":"49","author":"Zacharakis","year":"2015","journal-title":"Scand J Urol"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1111\/jsm.12803","article-title":"Malleable penile prosthesis is a cost-effective treatment for refractory ischemic priapism","volume":"12","author":"Tausch","year":"2015","journal-title":"J Sex Med"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"S125","DOI":"10.1038\/sj.ijir.3901086","article-title":"Reimplantation of inflatable penile prosthesis into scarred corporeal bodies","volume":"15","author":"Wilson","year":"2003","journal-title":"Int J Impotence Res"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.sxmr.2017.08.002","article-title":"Penile prosthesis implantation in priapism","volume":"6","author":"Y\u00fccel","year":"2018","journal-title":"Sex Med Rev"},{"key":"2023041308055117700_","first-page":"359A","article-title":"Simultaneous ultrex penile prosthesis reimplantation and Gore-Tex grafting corporoplasty functional outcome of a surgical challange","volume":"153","author":"Boyd","year":"1995","journal-title":"J Urol"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"2470","DOI":"10.1111\/j.1743-6109.2008.00912.x","article-title":"Implantation of penile prosthesis in cases of corporeal fibrosis: Modified Shaeer's excavation technique","volume":"5","author":"Shaeer","year":"2008","journal-title":"J Sex Med"},{"key":"2023041308055117700_","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1111\/j.1743-6109.2007.00582.x","article-title":"Penoscopy: Optical corporotomy and resection for prosthesis implantation in cases of penile fibrosis: Shaeer's technique","volume":"4","author":"Shaeer","year":"2007","journal-title":"J Sex Med"}],"container-title":["Sexual Medicine Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2050052119300046?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2050052119300046?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/smr\/article-pdf\/8\/1\/131\/49873262\/smr_8_1_131.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/smr\/article-pdf\/8\/1\/131\/49873262\/smr_8_1_131.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T17:17:31Z","timestamp":1694711851000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/smr\/article\/8\/1\/131\/6812671"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,19]]},"references-count":43,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,3,19]]},"published-print":{"date-parts":[[2020,1,1]]}},"URL":"https:\/\/doi.org\/10.1016\/j.sxmr.2019.01.001","relation":{},"ISSN":["2050-0521","2050-0513"],"issn-type":[{"value":"2050-0521","type":"electronic"},{"value":"2050-0513","type":"print"}],"subject":[],"published-other":{"date-parts":[[2020,1]]},"published":{"date-parts":[[2019,3,19]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Management of Priapism: A Contemporary Review","name":"articletitle","label":"Article Title"},{"value":"Sexual Medicine Reviews","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.sxmr.2019.01.001","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2019 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}