Priapism: an appraisal of surgical treatment.

The surgical outcome in 66 patients with priapism who presented at the University College Hospital, Ibadan, over a ten-year period was evaluated. Operative procedures carried out included bilateral cavernostomies in 23 patients, caverno-glandular shunts in 11, caverno spongiosal shunt in 18 and caverno-saphenous shunt in 1. Complete detumescence was achieved immediately postoperatively in all patients, however, this was not maintained. Some turgidity recurred after twenty-four hours in all patients. In 12 patients with recurrence of turgidity, 8 had flaccid penis after. Long-term results and follow up in these patients are scanty due to default, but of the 12 that were followed up for a period ranging from 2 months to 2 years, 6 are still able to achieve and maintain an erection, while 6 had no erection at all. Two of five patients who had conservative treatment are able to achieve and maintain an erection. The outcome of surgical treatment appears to be superior to conservative treatment. Bilaterial cavernostomies appear to be effective, but when this fails a shunt procedure should be carried out.