Ischemic Priapism and Implant Surgery with Sharp Corporal Fibrosis Excision (CME)


John Mulhall, MD, Memorial Sloan-Kettering Cancer Center, Urology, 353 E 68th St, New York, NY, 10021, USA. Tel: 646-422-4359; Fax: 212-988-0768; E-mail:


Introduction.  Prolonged ischemic priapism is commonly associated with severe erectile dysfunction. Subsequent implant surgery is complicated by fibrosis of corporal tissue.

Aim.  In this article we review clinical practice methods for safe and effective use of intracavernosal injection therapy as well as management of erectile dysfunction that may result from inappropriate priapism treatment.

Methods.  A case report is presented followed by a review of literature addressing surgical techniques for penile prosthesis implantation in the setting of corporal fibrosis.

Main Outcome Measures.  Review of literature and discussion of best-practice management.

Results.  Erectile dysfunction should be clearly distinguished from premature ejaculation. Careful training and monitoring of patients using penile self-injection therapy is essential for preventing episodes of priapism. Local injection clinics that are primarily motivated by financial considerations threaten the safe management of men with sexual dysfunction. Development of corporal fibrosis occurs during prolonged ischemic priapism and is duration-dependent. Implant surgeons should be familiar with maneuvers to address fibrotic corporal tissue. Stember DS, and Mulhall JP. Ischemic priapism and implant surgery with sharp corporal fibrosis excision. J Sex Med 2010;7:1987–1990.