A novel technique for contained aspiration and irrigation of priapism

Abstract

Abstract Background Ischemic priapism is a urological emergency requiring prompt corporal aspiration and irrigation, with risk of blood spillage that can place a significant biological hazard to the urologist and rest of emergency room staff. Aim The study sought to develop and validate a method for contained corporal aspiration that minimizes exposure to sharps and occupational hazards. Methods We used one large bore needle connected to a vacuum aspiration device and blood draw tubes for corporal aspiration and irrigation of ischemic priapism. Outcomes Feasibility of this method was assessed in 18 consecutive patients presenting to the emergency room with ischemic priapism. Clinical characteristics, resolution of priapism, and need for further interventions were documented. Results A total of 18 patients were treated using this technique. The mean time from onset to presentation was 12 hours. The etiology in all patients was recreational intracavernosal drug abuse, and 72% were HIV positive. Priapism completely resolved in all 18 patients. No patients required shunt procedures or further interventions to achieve detumescence. Clinical Implications This system can be used for safe management of ischemic priapism in any clinical scenario but is particularly beneficial to minimize exposure risk in the setting of increased risk of blood-borne infections. Strengths and Limitations This initial trial shows that this technique is safe and effective for cavernosal aspiration of ischemic priapism. Larger trials are required to validate this method. Conclusion Contained aspiration and irrigation of priapism can be used for effective management of ischemic priapism while minimizing health risks to urologists and emergency room staff.