EMERGENCY MANAGEMENT OF PRIAPISM: A COMPARATIVE STUDY OF CONSERVATIVE VS. SURGICAL INTERVENTIONS

Abstract

Background:
Priapism functions as a urological emergency because it creates an extended lasting erection which usually causes intense pain beyond four hours. Erectile dysfunction becomes permanent in patients who experience ischemic types without receiving timely treatment. The preservation of erectile function along with the prevention of complications depends on immediate decisions between non-interventional and surgical treatment approaches in patient management.

Objectives:
This study compares the treatment results as well as post-treatment risks and long-term outcomes between non-invasive and surgical approaches during emergency priapism management for adult male patients.

Study design: A prospective study.

Place and duration of study: Department of Urology, Pak International Medical College Peshawar. from January 2018 to December 2021.

Methods:
100 priapism cases that visited emergency departments over a period of January 2018 to December 2021. The study divided patients into two groups according to their received treatment: either conservative approaches including aspiration and phenylephrine usage and cold compression or surgical methods such as distal/proximal shunting alongside cavernoma decompression. The study obtained data about priapism duration together with intervention times and complications as well as erectile function assessment. SPSS version 24.0 performed the statistical analysis while p<0.05 determined statistical significance.

Results:
100 total patients included 30 participants who got conservative treatments and another 70 individuals received surgical care. The patient group aged on average 32.7 ± 9.5 years. The surgical group achieved better resolution outcomes compared to the conservative group with 85% in the former population and 97% in the latter (p=0.021). The rate of erectile dysfunction development was 10.3% in conservative treatment patients but 1.6% in patients who received surgery (p=0.034). Penile fibrosis and infection complications happened more frequently in the surgical intervention group at rates of 12.9% while the conservative group experienced rates of 5.2% (p=0.047). The surgical interventions brought about quick healing but patients experienced elevated risks of complications after surgery.

Conclusion:
Medical procedures prove significantly effective at treating priapism mainly in long-lasting ischemic situations despite bearing more complications. The successful resolution of priapism depends on conservative treatments in early situations yet these methods become less effective for delayed cases which may lead to erectile dysfunction. The selection of customized treatment depends on symptom times and patient health to produce the best results.