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Priapism whom it had lasted longer than seven days did The younger the patients the better the prognosis, so that 88% of those younger than 30 years preserved their potency but only 40% of those older than 50 years remained potent The prognosis was poorest when heparin therapy or a combination of alcohol drinking and psychopharmaceuticals was the etiologic factor behind priapism Only 31% of patients preserved their potency after conservative treatment for priapism, whereas 69% of those treated with small glanulo corporal shunts did so Chakrabarty et al retrospectively reviewed pediatric patients with sickle cell priapism and subsequently assessed erectile capabilities, subjectively by questionnaire, and objectively by RigiScan [10] Of the 15 patients interviewed, ve had undergone shunt procedures The return of potency tended to vary inversely with patient age at onset and duration of priapism Kaisary et al analyzed 22 patients with priapism [13] Fourteen various surgical shunts were carried out Success of surgical treatment, as demonstrated by detumescence and maintenance of potency, was best achieved in those patients who were treated less than 12 hours following onset of priapism, irrespective of whichever venous shunting technique was used (6/7 patients, 86%) Richard et al evaluated the records of 12 venocclusive priapism patients [15] Treatment consisted of eight sapheno cavernous shunts, achieving detumescence in seven cases, and preserving sexual potency in ve Moncada et al reported on ve patients with venocclusive priapism who underwent the Grayhack procedure Two patients had no brosis of the CCSM yet had complete erectile dysfunction after the operation Cavernosography revealed a patent shunt Potency returned after ligation and division of the saphenous vein In the other three cases cavernosography revealed thrombosis of the shunt Fibrosis of the cavernous tissues was believed to be the cause of erectile dysfunction in these cases The author suggested that in cases where erectile function does not return within three months of the Grayhack procedure, the shunt should be ligated.

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