{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T14:43:45Z","timestamp":1767624225784,"version":"3.48.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ischemic priapism persisting beyond 36\u00a0hours frequently results in irreversible corporal injury and erectile dysfunction, raising questions about whether surgical intervention is even necessary or worthwhile in these cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To compare outcomes of non-surgical vs surgical management in patients with ischemic priapism lasting \u226536\u00a0hours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective review of patients treated for ischemic priapism persisting \u226536\u00a0hours at our institution between January 2005 and October 2024. Patients were categorized into two cohorts based on initial treatment strategy: (1) non-surgical\u2014aspiration with or without irrigation and phenylephrine injection and (2) surgical\u2014T-shunt or Al-Ghorab shunt procedures, with or without corporal snaking, or penile prosthesis placement during the same admission. Demographic and clinical variables were compared using Wilcoxon-Mann\u2013Whitney, Fisher\u2019s exact, and chi-squared tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>Primary outcomes included reintervention and readmission rates; secondary outcomes included penile fibrosis and deformity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventy-six patients were included: 38 treated non-surgically and 38 surgically. Baseline characteristics, including age, comorbidities, and priapism etiology, were similar between groups. Median duration of priapism at presentation did not differ significantly (36\u00a0vs 48\u00a0hours, P\u2009=\u20090.41). The non-surgical group had a significantly higher rate of readmission and reintervention compared to the surgical group (66.7% vs 10.4%, P\u2009&amp;lt;\u20090.01). Deforming penile fibrosis was more frequent in the non-surgical group (18.5% vs 7.9%), although this difference was not statistically significant (P =\u20090.309).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Implications<\/jats:title>\n                    <jats:p>Conservative non-surgical management for prolonged ischemic priapism is associated with higher retreatment rates and complications, suggesting that a more definitive surgical approach may be more effective in managing these cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Strengths and Limitations<\/jats:title>\n                    <jats:p>This study provides real-world comparative data on management strategies for prolonged ischemic priapism in a consecutive patient cohort. Limitations include its retrospective, single-center design, small sample size, and limited long-term follow-up, which precluded assessment of erectile function and prosthesis outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In cases of ischemic priapism lasting &amp;gt;36\u00a0hours, non-surgical treatment is associated with higher failure and complication rates, supporting early surgical intervention to improve outcomes and reduce morbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jsxmed\/qdaf362","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T13:04:37Z","timestamp":1765285477000},"source":"Crossref","is-referenced-by-count":0,"title":["Non-surgical vs surgical management for major ischemic priapism of 36\u00a0hours 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