Complications

Complication
Timeframe
Likelihood
long term
high

Priapism is associated with functional and structural pathologic changes of the corpora cavernosa. Erectile tissue necrosis and genital organ fibrosis with deformity may develop.

long term
low

Serious complications have been reported following shunt procedures. Erectile dysfunction rates are higher (about 50%) for the proximal shunts and venous anastomoses (e.g., Quackels and Grayhack procedures) than with the distal shunts (≤25%), although patient selection and time to treatment may explain these differences. Other complications associated with shunt procedures include urethral damage and fistulas, purulent cavernositis, skin necrosis, perineal abscess, and pulmonary embolism following the Grayhack procedure.[50][51][52]

variable
high

Prolonged corporal ischemia leads to endothelial and smooth muscle cell necrosis and apoptosis.[48] Furthermore, anoxia and acidosis leads to erectile tissue impairment, including loss of tissue contractile responsiveness to alpha-adrenergic pharmacologic stimulation.[49]

variable
high

The most common complication of priapism is complete erectile dysfunction, which has been reported to occur in >50% of patients with priapism lasting 24-48 hours.[36]

Priapism is associated with functional and structural pathologic changes of the corpora cavernosa. Both ischemic and nonischemic priapism are associated with subsequent erectile dysfunction.[1]

Patients may seek management for erectile dysfunction following priapism, and they should be treated appropriately.

Oral phosphodiesterase-5 inhibitors as a treatment for erectile dysfunction in this population are generally not recommended. Preferred options such as vacuum erection device therapy, intracavernous pharmacotherapy, and placement of a penile prosthesis are recommended.

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