الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Priapism is defined as a prolonged penile erection (> or equals 4 hours) which is maintained without sexual stimulation and persists despite orgasm and ejaculation. it is an emergency requiring an urgent medical intervention and accurate diagnosis. Three broad categories exist for this disease: ischemic, non-ischemic, and recurrent ischemic.
Full history and physical examination are used to diagnose IP. It is mandatory to evaluate penile hemodynamics and metabolism of penile blood in the CC aspiration and laboratory examination of the blood obtained. To aid in the diagnosis of priapism, lab tests such as CBC, reticulocyte counts, haemoglobin electrophoresis, serum lactic dehydrogenase, and urine toxicology might be used. For the conformation of diagnosis of ischemic versus nonischemic causes of priapism. Intracorporeal arterial blood flow can be analyzed using color duplex ultrasound (CDU).
IP is a medical emergency. Timing is crucial, and when therapy is initiated quickly, better outcomes can be expected. Restoration of cavernous blood flow and prevention of more ischemic time is the primary goal in the management of IP. Management includes as the first line of treatment aspiration therapy with ICI of phenylephrine which is the preferred sympathomimetic. Phenylephrine produces vasoconstriction in the CC by acting as a 1-adrenergic receptor agonist. Aspiration provides relief in the pressure of CC, allowing natural intra-cavernosal blood flow to resume. IP that lasts longer than 48 hours can be difficult to treat with corporal aspiration, irrigation, or sympathomimetic ICI so surgical interventions may be applied as percutaneous distal shunting, open distal shunting, proximal shunting and Penile prosthesis
Given the low incidence of acute IP and heterogeneity of clinical presentation, durations of IP, there is a considerable lack of randomized-controlled studies that measure the safety and efficacy of stepwise management of IP. As a result, creating strict evidence-based guidelines to guide clinicians has been challenging. Fortunately, a strong approach for clinicians to manage IP is based on expert consensus and the most recent literature and it will remain a point of contention.
Standardization was achieved in this study through using the same conservative management as aspiration and ICI of sympathomimetic agent as diluted phenylephrine regardless the duration of IP which can be repeated up to three times, if non resolution of priapic status T-shunt was performed. RIP (after T-shunt) was managed by PSD. Regarding prolonged cases of IP (≥ 48 hours) this conservative management is found to be effective in resolving priapic statu