{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T12:27:42Z","timestamp":1766579262813,"version":"3.37.3"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Urology"],"published-print":{"date-parts":[[2017]]},"abstract":"<jats:p><jats:italic>Introduction<\/jats:italic>. The three types of priapism are stuttering, arterial (high-flow, nonischemic), and venoocclusive (low-flow, ischemic). These are usually distinct entities and rarely occur in the same patient. T-shunts and other distal shunts are frequently combined with tunneling, but a seldom recognized potential complication is conversion to a high-flow state.<jats:italic>Case Presentation<\/jats:italic>. We describe 2 cases of men who presented with low-flow priapism episodes that were treated using T-shunts with tunneling that resulted with both men having recurrent erections shortly after surgery that were found to be consistent with high-flow states. Case<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mrow><mml:mn fontstyle=\"italic\">1<\/mml:mn><\/mml:mrow><\/mml:math>was a 33-year-old male with sickle cell anemia and case<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mrow><mml:mn fontstyle=\"italic\">2<\/mml:mn><\/mml:mrow><\/mml:math>was a 24-year-old male with idiopathic thrombocytopenic purpura. In both cases the men were observed over several weeks and both men returned to normal erectile function.<jats:italic>Conclusions<\/jats:italic>. Historically, proximal shunts were performed only in cases when distal shunts failed and carry a higher risk of serious complications. T-shunts and other distal shunts combined with tunneling are being used more frequently in place of proximal shunts. These cases illustrate how postoperative erections after T-shunts with tunneling can signify a conversion from low-flow to high-flow states and could potentially be misdiagnosed as an operative failure.<\/jats:p>","DOI":"10.1155\/2017\/7394185","type":"journal-article","created":{"date-parts":[[2017,2,26]],"date-time":"2017-02-26T21:01:35Z","timestamp":1488142895000},"page":"1-4","source":"Crossref","is-referenced-by-count":3,"title":["Conversion of Low-Flow Priapism to High-Flow State Using T-Shunt with Tunneling"],"prefix":"10.1155","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4106-0232","authenticated-orcid":true,"given":"Neil A.","family":"Mistry","sequence":"first","affiliation":[{"name":"School of Medicine, Oregon Health & Science University, 3303 SW Bond Ave. CH10U, Portland, OR 97239, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas N.","family":"Tadros","sequence":"additional","affiliation":[{"name":"Department of Urology, Oregon Health & Science University, Portland, OR, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason C.","family":"Hedges","sequence":"additional","affiliation":[{"name":"Department of Urology, Oregon Health & Science University, Portland, OR, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"first-page":"749","volume-title":"Priapism","year":"2012","key":"1"},{"year":"2003","series-title":"8\/14\/2014","key":"2"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2009.01625.x"},{"volume":"51, article 269","journal-title":"Archivos Espa\u00f1oles de Urolog\u00eda","year":"1998","key":"4"},{"issue":"2","key":"5","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/S0022-5347(17)62672-7","volume":"99","year":"1968","journal-title":"Journal of Urology"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2008.01176.x"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2008.12.021"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2013.07.034"},{"issue":"3","key":"9","first-page":"174","volume":"7","year":"2010","journal-title":"Urology Journal"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.08.245"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2012.02973.x"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1007\/s12262-011-0273-y"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijir.3900828"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijir.3901398"},{"key":"15a","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2012.02692.x"},{"key":"15b","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/672624"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.20479"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1186\/1757-1626-1-429"},{"issue":"7","key":"18","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1182\/blood.V77.7.1405.1405","volume":"77","year":"1991","journal-title":"Blood"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-5347(01)67479-2"},{"issue":"1","key":"20","first-page":"60","volume":"3","year":"2009","journal-title":"Journal of the Canadian Urological Association"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-5347(01)63590-0"}],"container-title":["Case Reports in Urology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/criu\/2017\/7394185.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/criu\/2017\/7394185.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/criu\/2017\/7394185.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,3]],"date-time":"2020-10-03T03:37:42Z","timestamp":1601696262000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/criu\/2017\/7394185\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017]]},"references-count":22,"alternative-id":["7394185","7394185"],"URL":"https:\/\/doi.org\/10.1155\/2017\/7394185","relation":{},"ISSN":["2090-696X","2090-6978"],"issn-type":[{"type":"print","value":"2090-696X"},{"type":"electronic","value":"2090-6978"}],"subject":[],"published":{"date-parts":[[2017]]}}}