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Author: Admin | 2025-04-28
Case report Open access Published: 31 May 2018 BMC Urology volume 18, Article number: 54 (2018) Cite this article AbstractBackgroundRecurrent (stuttering) ischemic priapism is a challenging clinical condition. Frequent recurrences result in frequent hospital admissions whereas treatment with a shunting procedure often results in erectile dysfunction.Case presentationA 22-year-old man with stuttering idiopathic priapism developed erectile dysfunction (IIEF-5 score 12) following a Winter’s shunt; he was given tadalafil, 5 mg/daily, for 6 months. This treatment resulted in progressive restoration of erectile function in the 6 months following the shunt as well as in preventing recurrence of priapic episodes over a 24-month follow-up.ConclusionsThis is the first report in literature of chronic treatment of stuttering priapism with a phosphodiesterase-5 inhibitor being able not only to prevent recurrent priapic episodes but also to restore erectile function following a Winter’s shunt. Peer Review reports BackgroundRecurrent priapism, commonly known as stuttering priapism, is an unusual form of low-flow priapism that usually results in cavernous ischemia with consequent damage of erectile function. Sickle cell disease is considered the most common cause or stuttering priapism. Another large number of cases are classified as idiopathic, whereas non-erectogenic drugs or neurological disorders are rarely responsible for such condition.Primary treatment involves corporal aspiration followed by intracavernous injection of sympathomimetics [1]; in case of failure, a shunting procedure becomes mandatory. The most common shunting procedure remains the Winter’s shunt as it is quick and successful in 50 to 65% of cases [2, 3]. Unfortunately, the Winter’s shunt does not prevent recurrences [4, 5] and, on the other hand, leads to erectile dysfunction (ED) when the procedure is carried out within 24 h of priapism onset [6], therefore well before ischemia has led to definite cavernosal damage [7, 8]. Howewer, satisfactory results have been reported preservation of prepriapism erectile function, after 24 h
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