15. APPENDIX
Appendix 1
Table on medical management of ischaemic priapism
Author | Intervention Types (N, %) | Resolution of Priapism | Requirement for surgical management of refractory priapism | Sexual dysfunction | Side effects/ complications | Comments |
Ateyah | 122= Conservative Methods (122, 100%)Corporeal aspiration (92, 75,4%), Corporeal irrigation (70, 57.4%), Intracavernosal Sympathomimetics (10, 8.2%) | Conservative Methods (30, 24.6%), Corporeal aspiration (22, 23.9%), Corporeal irrigation (55, 78.57%), Intracavernosal Sympathomimetics (10, 100%) | NR | NR | NR | |
Baker | 9= Corporeal Aspiration (7,77.7%), Antiandrogens (9, 100%) | Immediate 5 (55.5%), total 8 (88.8%) | 1 (11.1%) | NR | 3 (33.3%) | |
Bansal | 9= Corporeal irrigation (9, 100%) | 6 (66.6%) | NR | NR | NR | |
Bardin | 10= Corporeal Aspiration (10, 100%), Corporeal Irrigation (10, 100%), Intracavernosal Sympathomimetics (4, 40%) | 7 (70%) | 3 (30%) | NR | 4 (40%) | |
Deholl | 9= Corporeal Aspiration (9, 100%), Corporeal Irrigation (9, 100%), Intracavernosal Sympathomimetics (6, 66.6%) | 6 (66.6%) | 3 (33.3%) | NR | NR | |
Dittrich | 36 Intracavernosal sympathomimetics (100%) | 36 (100%) | 1 (2.7%) | NR | NR | |
El-Bahnasawy | 50 Corporeal Aspiration (100%), Intracavernosal Sympathomimetics (100%) | Immediate 9 (18%), total 29 (58%) | NR | NR | NR | |
Farrer 1961 | 14 Conservative Methods (11, 78.4%), Corporeal Aspiration (14, 100%), Corporeal Irrigation (14, 100%) | 1 (7.1%) | NR | 8 (57.1%) | Corporeal fibrosis 1 (7.1%), time point NR | |
Forsberg 1981 | 9- Corporeal Aspiration (9,100%), oestrogens, sedatives, anticoagulants and anticholinergics (9, 100%) - epidural block (1, 11.1%) | NR | NR | 6 (66.6%) | NR | |
Gordon 2005 | 6= Conservative Methods (4, 66.7%), Intracavernosal sympathomimetics (2, 33.3%) | 6 (100%) | 0 | 1 (16.7%) | NR | |
Govier 1994 | 24= Terbutaline 5mg, (8, 33.3%), Terbutaline 2.5mg, (7, 29.2%), Placebo (9, 37.5%) | 13 (54.2%) | Terbutaline 6mg 3 (37.5%) vs Placebo: 5 (55.6%), Terb 2.5mg 3 (42.9%), p>0.05 | NR | NR | |
Grace 1968 | 17- Conservative Methods (17, 100%), Corporeal Aspiration (5, 29.4%), Pharmacological intervenions: anticoagulants 3, stilebstrol 3 (6, 35.3%) | non-systematic reporting - immediate resolution is <5% | NR | NR | wound infection, | |
Habous 2016 | 53= Conservative Methods (53, 100%), Corporeal Irrigation (14, 26.4%), Intracavernosal Sympathomimetics (3, 5.7%), Pharmacological Interventions: salbutamol (32, 60.4%) | Exercise: 21 (39.6%), salbutamol 18 (34%), aspiration + irrigation saline 11 (20.75%), 3 phenylephrine (5.7%) | 0% | NR | 0% | |
Hubler 2003 | 5= Intracavernosal sympathomimetics (Methylene Blue, 5, 100%) | Immediate 3 (60%), total 5 (100%) in 24 hours | 0% | all had ED pre-intervention | haematoma 5, burning sensation 5 (100%) | |
Jiang 2014 | 44= Intracavernosal sympathomimetics: Phenylephrine (44, 100%) | 44 (100% | 0% | Unclear but 18/44 had ED pre-procedure | throbbing sensation but unclear whether this was from phenylephrine or alprostadil | |
Kadioglu 1995 | 9= Intracavernosal sympathomimetics (Methylene Blue, 9, 100%) | 9 (100%) | 0% | 3 (33.3%) reported ED | pain 9 (100%) | |
Keskin 2000 | 19= Intracavernosal Sympathomimetics (adrenaline, 19, 100%) | Immediate 10 (53%), total 18 (94.7%) | 0% | 0% | 0% | |
Khurana 2002 | 9- conservative Methods (cold enema, 9, 100%), Corporeal Irrigation (1/9, 11.1%) | enema 5 (55.5%) , aspiration 1 (11.1%) | NR (3 pts referred to urological center for further management) | NR | NR | |
Kulmala 1996 | 53= Conservative Methods (16, 30.2%), Corporeal Aspiration (8, 15.1%), Corporeal Irrigation (17, 32.1%), Intracavernosal Sympathomimetics (12, 22.6%) | NR | NR | Conservative | NR | |
Kumar 2019 | 71 (no separate results on 69non-SCD pt): Corporeal Aspiration (71, 100%), some of the pts had phenylephrine but number unclear | 15 (21%) no separate results on non-SCD pts | NR | NR | NR | |
Larocque 1974 | 23= Conservative Methods (16, 69.6%), Corporeal Aspiration (7, 31.3%) | Conservative (5, 31.2%, includes various ways of management such as sedation, analgesics, exercise, ice packs, stilbestrol, enema, oxygen, proteolytic enzymes, epidural anaesthesia, sodium bicarbonate, low molecular weight dextran), aspiration (2, 28.6%) | NR | NR | NR | |
Lowe 1993 | 75= Pharmacological Interventions: (25 oral terbutaline, 25 oral pseudoephedrine, 50 placebo) | Terbutaline 9 (36%), Pseudoephedrine 7 (28%), Pbo 3 (12%), Terbutaline sig >Pbo | 0% | NR | NR | All non-responders were offered aspiration and irrigation (successful in all) |
Martinez Portillo 2001 | 12= Corporeal Aspiration (12, 100%), Corporeal Irrigation (12, 100%), Intracavernosal Sympathomimetics (2, 17%), Pharmacological Intervention (1, 8%) | Total 10 (83.3%%), all with corporeal injection | NR | no change in baseline ED function in patients with priapism due to corporeal injections. Leukaemia patient regained potency. Idiopathic patient impotent. | Temporary side effects: Burning sensation in 6/12, blue dis-colourisation in 4/12 | |
Molina 1989 | 12= Corporeal Aspiration (12, 100%), Corporeal Irrigation (12, 100%), Intracavernosal Sympathomimetics (12, 100%) | Irrigation and epinephrine, 10 (83.3%) | NR | Not specified individual data, "all patients who were spontaneously potent before continued to be potent"? 11/16 | NR | |
Moloney 1975 | 5= Conservative management, Corporeal Irrigation, Pharmacological Intervention (5, 100%, exact numbers not specified) | Unclear, but likely 5, 100% | NR | 2(40%) | NR | |
Muruve 1996 | 9= Intracavernosal Sympathomimetics (9, 100%) | Total 9, 100%; Sympathomimetics 8 (88.9%). Symapthomimetics followed by corporeal aspiration: 1 (11.1%) | 0(0%) | NR | minor haematoma in 1 patient | |
Pal 2016 | 19= Corporeal Aspiration (2, 11%), Intracavernosal Sympathomimetics (17, 89%) | Aspirin and ICI: 3 (15.8%) | 16(84%) | Unclear; 2/3 patients treated with aspiration and ICI had preserved erectile function | NR | |
Pantaleo-Gandais 1984 | 35= Conservative Methods (35, 100%) | Conservative management 4 (11.4%) | 31(88.57%) | Good sexual function in only 1/4 responders | NR | Mixed SCD and non-SCD population |
Passavanti 2009 | 17= Corporeal Aspiration (17, 100%), Corporeal Irrigation (17, 100%), Intracavernosal Sympathomimetics (7, 41%; adrenaline 5, and adrenaline + ethylephrine 2), Intracorporeal Sympathomimetics (Methylene Blue) | Total 12, (70.6%, 10 purely from methylene blue and aspiration and irrigation; 2 required additional ICI adrenalaine) | 4(24%) | NR | NR | |
Priyadarshi 2004 | 68= Pharmacological Interventions (34 Terbutaline, 34 Placebo, 100%) | 42% terbutaline group vs 15% placebo gp (p<0.05). | NR | NR | Tacycardia 34(30%) | |
Ridyard 2016 | 50 (mixed SCD and non-SCD pts): Intracavernosal Sympathomimetics: (38, 65%; phenylephrine alone), Intracavernosal Sympathomimetics and Corporeal Irrigation: (12, 21%; phenylephrine and irrigation) | 42 (84%) | overall 8(14%) [ICI (0%), idiopathic (14%), scd (0%), psychiatric medicines (37%), cocaine(05), PDE5inhibitors (0%), other (100%)) | NR | 0(0%) | |
Zhao | 136 episodes= Conservative Methods (25, 14.8%), Corporeal Aspiration/Irrigation (4, 2.4%), Intracavernosal Sympathomimetics (19, 11.4%), Combination of Corporeal Aspiration/Irrigation and Sympathomimetics (119, 70.4%) | 141 (84.6%) | 26 (15.4%) | NR | NR | |
Watters | 17= Intracavernosal Sympathomimetics (17, 100%) | 16 (94%) | 1(6%) | NR | NR | |
Vorobets | 10= Intracavernosal Sympathomimetics (10, 100%) | 0 (0%) | 10 (100%) | NR | NR | |
Van Driel | 8= Corporeal Aspiration (8, 100%), Intracavernosal Sympathomimetics (8, 100%) | 6 (75%) | 2(25%) | NR | NR | |
Ugwumba | 7= Corporeal Aspiration (7, 100%), Corporeal Irrigation (7, 100%), Intracavernosal Sympathomimetics (1, 14%) | 0 | 7(100%) | NR | NR | |
Torok | 72= Corporeal Aspiration (72, 100%), Intracavernosal Sympathomimetics (72, 100%) | 72 (100%) | 0(0%) | NR | NR | |
Stief | 29= Corporeal Aspiration (3, 10.3%), Intracavernosal Sympathomimetics (26, 89.7%) | 29 (100%) | NR | NR | NR | |
Sonmez | 46= Corporeal Aspiration (46, 100%), Corporeal Irrigation (46, 100%), Intracavernosal Sympathomimetics (4, 8.7%) | 39 (84.7%) | 7(15.3%) | NR | NR | |
Soler | 14= Conservative Methods (14, 100%), Corporeal Aspiration (2, 14%), Pharmacological Interventions (14, 100%) | 14 (100%) | 0(0%) | NR | piloerection | |
Serrate | 23= Intracavernosal Sympathomimetics (23, 100%) | 23 (100%) | NR | NR | NR | |
Saffoncuartas | 31= Conservative Methods (31, 100%), Corporeal Aspiration (1, 3.2%), Corporeal Irrigation (1, 3.2%), Intracavernosal Sympathomimetics (19, 61.3%), Pharmacological Interventions (1, 3.2%) | 31 (100%) | NR | NR | NR |
Appendix 2Table on Surgical shunts in ischaemic priapism
Study | n | Non-Surgical Intervention (%) | Surgical Intervention (n/ %) | Resolution of priapism (%) | Sexual function | Surgical adverse event |
Kumar | 71 | Penile aspiration +/- alpha adrenergic agonist irrigation n=24 (33%) | Distal shunt n=38(53%) [Winter shunt (n=30), Ebbehoj (n=6), Al-Ghorab (n=2)] Proximal shunt n=9(12%) [Quackle(n=6,) Grayhack (n=3)] | Distal shunt 42.01% Proximal shunt 55.55% Penile aspiration 21.12% | 21 (29.57%) patients followed up at 6 months n=15 (71.4%) reported moderate to severe ED | Complication following shunts (n=20, 42.5%) [Wound infection n=5, Shunt site bleeding n=14, skin necrosis n=1] |
Lian et al. 2010 | 12 | - | Corporospongiosal shunt with intracorporeal tunnelling (n=12) | 100% | Average FU 21.6+/-10.1 months IIEF5 score 11.7+/-6.3 post treatment (vs 23.7+/- 1.1 prior to priapism) | No severe complications noted |
Macaluso et al. 1985 | 34 | n=29 (85.2%) had initial conservative treatment | 12/29 patients (41.3%) required surgery with Winter’s shunt | 100% with Winter’s shunt | - | Overall complications from surgery 5/12 (41.6%) [Urethral injury (n=1), Penoscrotal haematoma (n=3), Epididymitis (n=1)] |
Moloney et al. 1975 | 11 | - | Saphenocavernous bypass (n=12) | 100% | 70% ‘good’ if functional outcome’ and 30% ‘fair functional outcome’ | - |
Muneer | 60 (stuttering) | 100% initial non- surgical treatment | Surgical procedures in n=12 [Penile prosthesis n=3, embolisation n=5, Winter shunt n=1. El-Ebbehoj n=1, Cavernosal ligation n=1) | Success rate 100% for Penile prosthesis, 20% for embolisation and 0% for other surgical therapies | - | - |
Nelson | 48 | - | Winter’s shunt (n=8) Saphenocavernous bypass (n=3) | Shunt success 10/11 (failed in single case when done in priapism due to sickle cell disease) | 50% potency rate in patients treated by aspiration followed by shunting | - |
Nixon | 28 | - | Winter’s shunt (n=14) Al Ghorab Shunt(n=13) Quackle shunt (n=1) | Winters shunt 14.2% (n=12 required reoperation) Al Ghorab 92% (n=1 required reoperation) Quackle 100% success | 2/20 available patients for FU (10%) had preserved erectile function following shunt surgery | - |
Pantaleo-Gandais | 35 | 100% had initial conservative management | Surgery required in 31 cases (88.57%) [corporocavernosal incision n=8, cavernous spongiosum shunt n=9, cavernous-saphenous shunts n=4, Ebbehoj n=9, Winters n=1) | Overall 85.7% success across all shunts | 100% preservation of sexual function if priapism <3 days duration (n=17) 11.1% preservation of sexual function if priapism>3days | - |
Ugwumba et al. 2015 | 15 | 13/15 (86.6%) had initial conservative treatment prior to shunting | Glanulo-cavernous (Al-Ghorab) shunt n=15 (100%) | Immediate detumescence (n=14,93.3%) Delayed detumesence (n=1, 6.7%) | 46.7% ED | |
Lawani | 66 | 100% had initial conservative treatment | Surgical procedures in 53/66 (80.3%) [bilateral cavernotomies n=23, cavernoglandular shunt n=11, cavernospongiosal shunt n=18, cavernosaphenous shunt n=1] | 100% immediate detumesence post-surgery | 50% ED rate in 12 patients who had follow-up | - |
Pal et al. 2016 | 19 | 100% had aspiration prior to surgery | 16/19 (84%) had surgery Al Ghorab shunt (n=6) Quackle shunt (n=5)] | 18.7% | Preservation of erectile function 66.7% for aspiration only 18.1% for | N=3 (15.7%) had complications [urethral |
Wendel | 8 | - | Corporo cavernosa –glans penis shunt (n=8) | 87.5% success rate | - | - |
Kihl et al. 1980 | 31 | - | Saphenocavernous shunting (n=26) | 76.9% initial success | 7/26 (26.9%) potent at | N=5 (19.2%) complication rate [Urethrocutaneous fistula n=1, haematoma n=2, thrombophlebitis n=1, altered sensation n=1] |
Kilinc et al. 2009 | 15 | Cavernosal-cephalic vein shunt (n=15) | 86.6% success | 3/13 (23) reported ED at 12 months | No major complications reported | |
Klufio et al. 1991 | 20 | Al Ghorab shunt (n=20) | All had immediate detumescence (100%) | 39% potency rate | 10% complication rate (post-operative bleeding n=2) | |
Adeyato | 54 | N=19 (35%) | N= 35 (65%) | 2/35 (5.7%) had recurrence in the immediate postop period | Potency rate 47.37% conservative vs 70.37% for shunt | - |
Aghagi | 35 | All had prior conservative treatment | N=35 had surgery | 100% detumesence postop | 8/35 (22.8%) had absent erections post-surgery | - |
Brant et al. 2009 | 13 | All had prior conservative treatment | T shunt (n=13) | 12/13 (92%) | 84.6% erectile function | No major surgical complications |
Canguven et al. 2013 | 15 | - | Transient distal penile shunt | 10/15 (66% success rate) | - | - |
Carter | 12 | - | Corporosaphenous shunt (n=2) Cavernospongiosum shunt (n=10) | Not clear | 100%ED in corporosaphenous shunt 4/7 (57.1%) potency rate following cavernospongio-sus shunt | |
Chary | 8 | - | Caverno-glandular shunt (n=8) | 100% success | 50% potency rate | (n=1 cavernositis, 12.5%) |
Klein et al. 1972 | 9 | - | Corpus saphenous shunt (n=9) | 22.2% (n=2) had partial response immediately | 11.1% potency rate |
Appendix 3Table on penile prosthesis insertion for ischaemic priapism
Study | n | Non-Surgical Intervention (%) | Surgical Intervention (n/ %) | Resolution of priapism (%) | Sexual function | Surgical adverse event |
Rees et al. 2002 | 8 | All had prior conservative treatment | Penile prosthesis n=8 (4 had prior shunt) | All implants successful (mean duration of priapism at presentation 91h) | 7/8 (87.5%) sexually active 100% satisfaction in those sexually active | N=1 penile deformity for revision due to fibrosis around cylinder |
Zacharakis et al. 2014 | 95 | All had prior conservative treatment | N=68 penile implants (early median 7 days) vs n=27 delayed implants (median of | 100% | 25/95 (26.3%) able to have intercourse Satisfaction 96% for immediate implant vs. 60% for delayed group | 13/95 (13.6%) required revision surgery due to complications |
Salem et al. 2010 | 12 | All had prior conservative treatment | 12 acute | 100% | 100% achieved intercourse | No revision surgery required No postoperative complications noted |
Sedigh et al. 2011 | 20 | N=6 non-surgical treatment | N=10 shunts (n=5 of those had early penile prosthesis) | 100% | 100% satisfaction with prosthesis 100% of penile prosthesis group sexually active | No complications from prosthesis insertion |
Zacharakis et al. 2015 | 10 | - | N=10, malleable penile prosthesis | 100% | 80% satisfaction as per IIEF at 3 months | No erosion or urethral injury noted |
Appendix 4Table on series of early and delayed penile prosthesis implantation secondary to priapism
Study | n: early/delayed | n: priapism/total | n: malleable/ inflatable | Technique | Mean follow-up (months) | Complications | Outcomes |
Small [2078] | 0/4 | 4/4 | 3/0 | Sharp dissection | 38 | inability (1) | Success (3) |
Bertram et al. [2079] | 0/6 | 6/6 | 4/1 | Sharp dissection | N/A | inability (1) | Success (5) |
Kelami [2080] | 0/12 | 12/12 | 12/0 | N/A | N/A | N/A | N/A |
Mireku-Boateng [2081] | 2/0 | 2/2 | 2/0 | N/A | 36 | - | Success (2) |
Douglas et al. [2082] | 0/5 | 5/5 | 5/0 | Excavation | 48 | Urethral erosion (2), revision (1) | Success (4) |
Kabalin [2083] | 0/1 | 1/1 | 1/0 | corporotomy | N/A | Inability to insert inflatable prosthesis | Success (1) |
Knoll et al. [2084] | 0/20 | 2/20 | 0/20 | Downsized device | 20 | Infection (1), mechanical | Success (19) |
Herschorn et al. [2085] | 0/11 | 2/11 | 2/9 | PTFE graft | 46 | Revision (3) | Success (8) |
George et al. [2086] | 0/12 | 2/12 | 7/5 | Scar excision (12), PTFE graft (1) | 22 | Perforation (1), malfunction (1) | Success (11) |
Sundaram [2087] | 1/0 | 1/1 | 0/1 | N/A | 8 | - | Success (1) |
Upadhyay et al. [1402] | 1/0 | 1/1 | 1/0 | N/A | 6 | - | Success (1) |
Rajpurkar et al. [2088] | 0/34 | 4/34 | 11/23 | Multiple incisions+ scar excision | 23.7 | Perforation (1), malfunction (1) | Success (34) |
Mooreville et al. [2089] | 0/16 | 3/16 | 0/16 | Cavernotom+ Downsized (14) | N/A | Perforation (6), crossover (3) | Success (16) |
Ghanem et al. [2090] | 0/17 | 5/17 | 10/7 | Corporal counter incision | N/A | Perforation (1) | Success (17) |
Park et al. [2091] | 0/1 | 1/1 | 0/1 | Narrow base, evaporisation | 12 | - | Success (1) |
Montague et al. [2092] | 0/9 | 4/9 | 0/9 | Excavation, downsized (7) | 44 | Malfunction (1) | Success (9) |
Shaeer [2093] | 0/12 | 4/12 | 8/4 | Shaeer excavation | N/A | - | Success (12) |
Durazi et al. [2094] | 0/17 | 17/17 | 11/6 | Corporotomy + partial excavation | 22.7 | Urethral injury (2) | Success (17) |
Lopes et al. [2095] | 0/8 | 3/8 | 8/0 | Bovine pericardium graft | 32 | - | Success (5) |
Ralph et al. [1399] | 50/0 | 50/50 | 50/0 | Hegar dilator | 16 | Infection (3), revision for erosion (3), cylinders too short (2), autoinflation (1), penile curvature (1) | Success (48) |
Salem et al. [1400] | 12/0 | 12/12 | 12/0 | N/A | 15 | Significant penile shortening | Success (12) |
Stember et al. [2096] | 0/1 | 1/1 | 0/1 | Narrow base, sharp corporal excision | 3 | Urethral injury (1) | |
Sedigh et al. [1401] | 5/0 | 5/5 | 1 /4 | N/A | N/A | Urethral injury (1) | Success (5) |
Bella et al. [1404] | 0/5 | 5/5 | 0/5 | Rosello dilator | N/A | Urethral injury (1) | Success (5) |
Egydio et al. [2097] | 0/69 | 24/69 | 57/12 | Double-windsocks | 22.5 | Urethral injury (4) | Success (42), Somewhat satisfaction (19) |
Razzaghi et al. [2098] | 14/0 | 14/14 | 14/0 | N/A | 14 | - | Success (14) |
Zacharakis et al. [1311] | 68/27 | 95/95 | 76/19 | Downsized (15 in delayed group) | 17 | Infection (5), penile curvature (1) | 96% success in early group / 60% success in delayed group |
Tausch et al. [2099] | 14/0 | 14/14 | 14/0 | N/A | N/A | Infection (1), distal extrusion (1) Urethral injury (1) | Success (14) |
Faddan et al. [2100] | 1/0 | 1/1 | 1/0 | N/A | N/A | Success (1) | |
Bozkurt et al. [2101] | 0/2 | 1/2 | 1/1 | Use of microdebrider for excavation | 12 | - | Success (2) |
Tsambarlis et al. [1405] | 0/13 | 2/13 | 0/13 | use vacuum device preoperatively | N/A | Infection (1), revision (1) | Success (12) |
Hebert et al. [2102] | 30/42 | 14/72 | 0/72 | Rosello dilator, downsized (63) | 12 | urethral injury (2), corporal perforation (15), cross-over (5), inability to dilate (1), infection (3), urethral erosion (2), glans erosion (7) | 87% success in early group / 67% success in delayed group |
Summary | 198/344 | 317/542 | 311/229 | Excavation, Shaeer technique, Rosello cavernotome, excision of scar, downsized | 22.4 | Infection: early 1-10% / delayed 3-20% Perforation, crossover or erosion: early | Success rate: early 87-100% / delayed 60-100% |
Appendix 5Table on embolisation for non-ischaemic priapism
Study | n | Non-Surgical Intervention (%) | Surgical Intervention (n/ %) | Resolution of priapism (%) | Sexual function | Surgical adverse event |
Bastuba et al. 1994 | 7 | - | Embolisation (n=7) post traumatic | 100% resolution between 4 – 126 | Full erectile function return at 2weeks-5months | - |
Bartsch et al. 2004 | 9 | - | Embolisation (n=9) post trauma | 8/9 (88.8%) success; once case required repeat embolisation | 100% potency | Coil displacement in1 case requiring repeat procedure |
Baba et al. 2007 | 6 | - | Embolisation (n=9) with gelatine sponge or microcoil | Detumesence achieved in 83.3% at 1 months and 100% within ‘few months’ | 100% normal erectile function | - |
Liu et al. 2008 | 8 | - | Embolisation with gelatine (n=2, 25%) Embolisation with microcoil(n=6, 75%) | 100% redo embolisation in gelatine group at 100% success rate from microcoil embolisation | Mean IIEF 22.2 at 6 months post embolisation | - |
Miller et al. 1995 | 5 | - | Embolisation with gelatine (n=4) Embolisation with autologous clot (n=1) | 100% | - | - |
Numan et al. 2008 | 11 | - | Embolisation with autologous clot (n=11) | 100% initial success Repeat embolisation required in 27.2% (n=3) | 100% erectile function restoration at 6 weeks | - |
Kim et al. 2007 | 27 | - | Embolisation (autologous clot n=12, gelatine sponge n=12, microcoil and Sponge n=1, polyvinyl n=1, Nbutylcyanoacrylate n=1) | 89% following first embolisation 7% required repeat embolization 4% subsequent shunt surgery | No change in premorbid erectile function (78%) | |
Cantasdemir et al. 2010 | 7 | - | Embolisation (n=7) | 6/7 (85.7%) complete detumescence (n=1 required redo embolisation) | No signs of ED detected at mean FU of 6 years | - |
Chick et al. 2018 | 20 | - | Embolisation using autologous clot, micocoil, polyvinyl or combination (n=20) | 18/20 (90%) success | Mean IIEF score post embolisation 25.8 | - |
Ciampalini et al. 2002 | 10 | - | Embolisation (n=9, 90%) Artery ligation (n=1, 10%) | 44% recurrence rate following first embolisation | Sexual function preserved in 80% | - |
DeMagistris et al. 2020 | 9 | - | Embolisation with microcoils, microparticles or spingostran (n=11) | 100% immediate detumescence 2/9 (22% required retreatment at 1-2 weeks) | Erectile function preserved compared to premorbid state | No major complications |
Gorich et al. 2002 | 6 | - | Embolisation with gelatine (n=3) and microcoil (n=3) | 100% success | 100% potency | - |