Therapeutic outcomes and analysis of Doppler findings in 25 patients with non-ischemic priapism

Non-ischemic priapism (NiP) is painless partial tumescence caused by genital trauma and the formation of intracorporal arterio-venous fistula. This is a retrospective study of 25 men with NiP and reports the long-term erectile function and colour doppler ultrasound (CDUS) findings after treatment for NiP. Unstimulated CDUS was performed at diagnosis, 1 week and at last follow-up after treatment. CDUS traces were analysed: peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI) and mean velocity (MV) were calculated. Erectile function was assessed using the IIEF-EF questionnaire. At the last follow-up (median 24 months), 16 men had normal erectile function (64%): median IIEF-EF score 29 (IQR 28.5-30; sigma(2) 2.78) and nine had erectile dysfunction (36%): median IIEF-EF score 17 (IQR 14-22; sigma(2) 33.6). MV and EDV were statistically higher in those patients with erectile dysfunction at last follow-up compared to patients with normal erectile function: median MV 5.3 cm/s (IQR 2.4-10.5 cm/s; sigma(2) 34) vs 2.95 cm/s (IQR 1.03-3.95; sigma(2) 3.4) p < 0.002 and median EDV 4.0 cm/s (IQR 1.5-8.0; sigma(2) 14.7) vs 0 cm/s (IQR 0-1.75; sigma(2) 2.21) p < 0.004. Erectile dysfunction was observed in 36% of men treated for NiP and was associated with abnormal low resistance resting CDUS waveforms. Further investigation for persistent arteriovenous fistulation should be considered in these patients.