Therapeutic outcomes and analysis of Doppler findings in 25 patients with Non-ischemic Priapism

Abstract Non-ischemic priapism (NiP) is painless partial tumescence caused by genital trauma and the formation of intracorporal arterio-venous fistula (AVF). This retrospective study aims to determine the long-term erectile function (EF) after NiP and to correlate this with colour doppler ultrasound (CDUS) parameters in 25 patients. EF was assessed by IIEF domain A questionnaire and CDUS parameters (mean velocity (MV), peak systolic velocity (PSV), end diastolic velocity (EDV) and Resistive Index (RI)) at diagnosis and follow up. At a median follow-up of 24 months: 16 men had normal EF (64%) with median IIEF score 29; nine had erectile dysfunction (ED) (36%) with a median IIEF-EF score 17. Raised MV and EDV on late follow-up CDUS traces demonstrated a statistically significant correlation with developing ED: median MV 5.3cm/sec vs 2.95cm/sec and median EDV 4.0cm/sec vs 0cm/sec in patients with ED compared to those with normal EF p < 0.002 and p < 0.004. The abnormal low resistance blood flow suggests ED may be attributed to persistent arterio-venous shunting.