[Surgery for priapism (author's transl)].

UNLABELLED: The authors review the literature with regard to surgery for priapism performed in 138 patients: 92 treated by uni- or bilateral sapheno-cavernous anastomosis and 46 by spongio-cavernous shunt. Sapheno-cavernous anastomosis: in 92 cases operated upon, there were 65 useable records. Conservation of potency in 61.5% of cases (40 out of 65) in particular in young patients aged 40 years or less where the rate of conservation of virility was 73.8%. After the age of 40, this rate fell to 39.1% of cases. It was surprising to note that the results were similar whether the operation was performed during the first 48 hours or later. Results were better after unilateral anastomosis (72.5% of cases with conservation of erection), than after bilateral surgery (54.5% conservation of erection). COMPLICATIONS of this type of surgery consisted of pulmonary embolism and necrosis of the penis. Spongio-cavernous anastomosis: 42 published cases but only 32 useable. Overall, 62.5% of cases with conservation of erection. Results were better before the age of 40 (70% success) than in older patients (50% success). Once again, the functional result obtained was independent of the period for which priapism had been present preoperatively. COMPLICATIONS: urethrocutaneous and urethro-cavernous fistulae. Comparison of the two types of operation failed to reveal any difference before the age of 40 years. By contrast, after 40 spongio-cavernous anastomosis gave slightly superior results (50% as against 39% for sapheno-cavernous anastomosis). On the basis of this general review, the authors drew a more favourable impression of caverno-spongious anastomosis.