Avoiding complications: surgery for ischemic priapism

Ischemic, or low-flow, priapism is among the most common and challenging urologic emergencies. Management of recurrent or refractory ischemic priapism is even more challenging, with increasing levels of risk for both the patient and the urologist. The goal of this commentary is to condense a career of experience (TF Lue) in the management of ischemic priapism into a concise, practical clinical tool for the reader. We will describe our current algorithm for the treatment of ischemic priapism in addition to detailing how we arrived at these recommendations. We will also describe why we believe that the presented approach is the best available approach and why we have turned away from alternative procedures.