Caverno Saphenous Shunt Priapism:

The Grayhack shunt (proximal cavernosal-saphenous shunt) surgically links the proximal corpora cavernosum to the saphenous vein. Priapism. The Grayhack shunt (proximal cavernosal-saphenous shunt) surgically links the proximal corpora cavernosum to the saphenous vein.

Surgical therapy aims to create a shunt between the corpus cavernosum and the glans penis, corpus spongiosum, or a vein, bypassing the clogged venoocclusive mechanism.

Penile shunt surgery is used to re-establish blood circulation and provide an outlet for blood in the penis. The corpora cavernosa and the glans of the penis form a link (or "shunt"). If you want to learn more about the strategies employed, talk to your doctor.

Disease Overview:

Priapism

A prolonged erection of the penis is referred to as priapism. The complete or partial erection lasts for hours or does not occur as a result of sexual stimulation. Ischemic and nonischemic priapism are the two most common kinds of priapism. Ischemic priapism is a serious medical condition.

Disease Signs and Symptoms:

• Erection that lasts longer than four hours or is unrelated to sexual arousal or interest.
• The penile shaft is rigid, but the penile tip (glans) is soft.
• Penile ache that is becoming worse.

Disease Causes:

Erections are usually triggered by physical or psychological stimulus. Certain smooth muscles relax as a result of this stimulation, boosting blood flow to spongy tissues in the penis. The blood-filled penis grows erect as a result. The blood drains from the penis after stimulation, and it returns to its nonrigid (flaccid) form.

When an element of this system – the blood, arteries, smooth muscles, or nerves — alters normal blood flow and an erection persists, it is called priapism. The underlying cause of priapism is frequently unknown, however various factors may be involved.

• Disorders of the blood
• Blood-related disorders can cause priapism, especially ischemic priapism, which occurs when blood cannot flow out of the penis. These illnesses include:
• Sickle cell disease is a kind of sickle cell illness.
• Leukemia
• Other blood disorders (hematologic dyscrasias), such as thalassemia and multiple myeloma, are examples of hematologic dyscrasias.
• Sickle cell disease is the most prevalent concomitant diagnosis in children.

Medications on prescription

Priapism, especially ischemic priapism, is a side effect of a variety of medications, including:

Alprostadil (Caverject, Edex, and others), papaverine, phentolamine (Oraverse), and other medications injected directly into the penis to treat erectile dysfunction.

fluoxetine (Prozac), bupropion (Wellbutrin XL, Wellbutrin SR), trazodone, and sertraline are antidepressants (Zoloft)

Prazosin (Minipress), terazosin, doxazosin (Cardura), and tamsulosin are all alpha blockers (Flomax)

Medications such as hydroxyzine (Vistaril), risperidone (Risperdal), olanzapine (Zyprexa), lithium (Lithobid), clozapine (Clozaril), chlorpromazine, and thioridazine are used to treat anxiety and psychotic disorders.

Warfarin (Jantoven) and heparin are blood thinners.

Testosterone and gonadotropin-releasing hormone are examples of hormones.

Methylphenidate (Concerta, Ritalin, and others) and atomoxetine are two medications used to treat attention deficit hyperactivity disorder (ADHD) (Strattera)

Use of alcohol and other drugs

Priapism, particularly ischemic priapism, can be caused by alcohol, marijuana, cocaine, and other substances.

Injury

Trauma or damage to the penis, pelvis, or the area between the base of the penis and the anus are all common causes of nonischemic priapism (perineum).

Other considerations

Priapism can also be caused by:

• A spider bite, a scorpion sting, or other illnesses that are poisonous
• Gout and amyloidosis are examples of metabolic diseases.
• Spinal cord injuries and syphilis are examples of neurogenic diseases.
• Penis cancers are cancers that affect the penis.

Disease Diagnosis:

Penile blood gas measurement is one example of a diagnostic test. A small needle is put into your penis to extract a sample of blood for this test. The disease is most likely ischemic priapism if the blood appears black, indicating a lack of oxygen.

Tests on the blood. The quantity of red blood cells and platelets in your blood may be measured using blood collected from your arm. Diseases such as sickle cell disease, other blood abnormalities, or some malignancies may be detected in the results.

Ultrasound. Doppler ultrasonography is a noninvasive technique that uses high-frequency sound waves (ultrasound) to measure blood flow via blood arteries by bouncing them off circulating red blood cells. This test can be performed to determine if you have ischemic or nonischemic priapism by measuring blood flow within your penis. The exam may also uncover an injury or anomaly that is the root of the problem.

Toxicology examination. A blood or urine test may be ordered by your doctor to check for medicines that might be causing priapism.

Disease Treatment:

Priapism due to ischemia

Ischemic priapism, which occurs when blood is unable to escape the penis, is a medical emergency that requires rapid attention. This treatment generally begins with a mix of blood draining from the penis and the use of drugs after pain alleviation.

Decompression of aspiration A tiny needle and syringe are used to remove excess blood from your penis (aspiration). The penis may also be flushed with a saline solution as part of this operation. This therapy soothes discomfort, eliminates oxygen-depleted blood, and may even prevent erections. This procedure can be continued until the erection is no longer present.

Medications. Your penis might be injected with phenylephrine or another medicine. This medication constricts blood arteries in the penis that transport blood.

Blood veins that transport blood out of the penis expand up as a result of this motion, boosting blood flow out of the penis. If necessary, this therapy might be repeated numerous times. If you have high blood pressure or heart problems, you will be closely watched for side effects such as headaches, dizziness, and high blood pressure.

Surgery or other procedures may be required. If such therapies fail, a surgeon may undertake further operations to drain blood from the penis or surgery to redirect blood flow so that blood may flow freely again.

If you have sickle cell disease, you may be given extra therapies to help you cope with illness-related symptoms.

Nonischemic Priapism

Nonischemic priapism frequently resolves on its own. Your doctor may recommend a wait-and-see strategy because there isn't a danger of injury to the penis. Using cold packs and applying pressure to the perineum (the area between the base of the penis and the anus) may aid in the erection's termination.

In certain situations, surgery may be required to put material, such as an absorbable gel, into your penis to temporarily stop blood flow. The substance is finally absorbed by your body. Surgery may also be required to repair arteries or tissue damage caused by an accident.