Guidelines

Sexual and Reproductive Health

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
at 3 weeks;
at 6 weeks, 1/3 had 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
5 (31%), Incision + Aspiration 3 (38%), Puncture + Lavation 12 (71%), Puncture +Alpha sympatho-mimetics 11 (92%)

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
et al. 2019

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
et al. 2008

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
et al. 1976

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
et al. 2003

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
et al. 1984

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
ED increased if presentation was >24h


Lawani
et al. 1999

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
[Winter’s shunt (n=16)

Al Ghorab shunt (n=6)

Quackle shunt (n=5)]

18.7%
Winter’s shunt
66.7%
Al Ghorab shunt
62.5%
Corporal snake
60%
Quackle’s shunt

Preservation of erectile function 66.7% for aspiration only 18.1% for
proximal shunts
20% for distal shunts

N=3 (15.7%) had complications [urethral
injury n=1, cavernositis n=1, skin necrosis n=1)

Wendel
et al. 1981

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
23.1% required further shunting

7/26 (26.9%) potent at
months – 10 yrs

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
(n=2 required further saphenocaver-nosal shunt)

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
et al. 2009

54

N=19 (35%)

N= 35 (65%)
Ebbhoj’s shunt

2/35 (5.7%) had recurrence in the immediate postop period

Potency rate 47.37% conservative vs 70.37% for shunt

-

Aghagi
et al. 2000

35

All had prior conservative treatment

N=35 had surgery
[Perineal cavernospongiosal shunt (n=14), modified corporospongiosal shunt (n=21)]

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%)
had resolution (n=1 required further T shunt)

84.6% erectile function

No major surgical complications

Canguven et al. 2013

15

-

Transient distal penile shunt

10/15 (66% success rate)

-

-

Carter
et al. 1976

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
et al. 1981

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
5 months)

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
failure (1), hypoesthesia (2)

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
prothesis with grafting

22.4

Infection: early 1-10% / delayed 3-20% Perforation, crossover or erosion: early
11% / delayed 13% Urethral injury: early 1% / delayed 3%

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
days

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
at 4 weeks

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
at 5 years

-

Liu et al. 2008

8

-

Embolisation with gelatine (n=2, 25%)



Embolisation with microcoil(n=6, 75%)

100% redo embolisation in gelatine group at
1 week

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

-