Low-flow priapism: results of surgical treatment on erectile function in Abidjan, Ivory Coast, from 2018 to 2022

Abstract

Introduction: Low-flow priapism, or venous priapism, is defined as an abnormally prolonged erection (lasting more than 3 to 4 hours) that is irreducible and sometimes painful, occurring after orgasm or in the absence of any sexual desire or stimulation. The increasing frequency of priapism and the difficulties in treating it motivated us to conduct this study, the objective of which was to present the functional results after surgical treatment.

Patients and methods: We conducted a retrospective descriptive study of patients hospitalised in the urology department of the Cocody Abidjan University Hospital - Ivory Coast between January 2018 and December 2022 for low-flow priapism. We included in the study all patients who underwent surgery for low-flow priapism and who had good erectile function prior to surgery. Erectile function was assessed using the International Index of Erectile Function (IIEF5).

Results: The average age of the patients was 32.35 years. Sickle cell patients accounted for 39.13% of cases. The average time to admission was 50.74 ± 45.50 hours (the duration range was 6 hours). The average time to treatment was 239.13 +/- 171.73 min or 4 hours by doctors (the duration range was 1 hour). After a 24-month follow-up, 34.78% of patients had mild erectile dysfunction, 34.78% had moderate erectile dysfunction, and 30.44% had severe erectile dysfunction.

Conclusion: Priapism should be considered a major andrological emergency requiring immediate treatment. The prognosis depends mainly on the age of the patient and the delay in treatment. Treating risk factors and early intervention are the best ways to avoid this condition, which compromises the functional prognosis of the penis.