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The first-line treatment for low-flow priapism is drawing blood from the corpus cavernosum. The penis is numbed, aspirated for blood, and then irrigated with saline and drugs called alpha-agonists (if necessary) injected into the corpus cavernosum. This procedure has a high rate of success and can be repeated in time.

Second-line treatment typically refers to penile surgery. It should be used in case of emergency, only after conservative and first-line treatments have failed.

There are two main types of surgery for low-flow priapism: penile shunt surgery and penile prosthesis implantation.

Penile shunt surgery

Penile shunt surgery is performed to restore an exit for blood and to re-establish blood circulation within the penis. A connection (“shunt”) is created between the corpora cavernosa and the glans of the penis. Talk to your doctor if you would like more information about the techniques used.

Fig. 1: Shunt procedure.
Fig. 1: Shunt procedure.

Penile prosthesis implant

Penile prosthesis implantation can be performed immediately if shunt surgery does not work or if low-flow priapism has lasted 48-72 hours. Prolonged low-flow priapism can cause fibrous tissue to develop in the penis and cause permanent damage.

Fig. 2: A common type of inflatable penile implant.
Fig. 2: A common type of inflatable penile implant.
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