Penoscrotal Decompression of Refractory Ischemic Priapism: Surgical Technique

Authors: Nicholas Ottaiano, Ganesh Sanekommu, Christopher Koller, Wayne Hellstrom, Allen Morey, Omer A. Raheem

Key Words: Priapism, Penoscrotal Decompression, Refractory Ischemic Priapism

The video covers the etiology and multiple causes of each subtype of priapism with a special emphasis on a newer surgical technique, penoscrotal decompression. Outcomes after distal shunting have low rates of success in cases of refractory ischemic priapism lasting more than 48 hours. Current American Urological Association (AUA) guidelines recommend proximal shunting following a failed distal shunt; however, proximal shunting is no longer common practice due to the technically challenging nature of the procedure. Corporal decompression via a penoscrotal incision has recently emerged as a viable alternative to proximal shunting with favorable outcomes. In the video, we describe the technique in a step-by-step fashion as well as the preoperative workup and outcome.

Acknowledgement: None

Disclosures: The authors have nothing to disclose