The DOI matches its Crossref record; 3 of the 3 references it cites were found in a registry or an index.
Early vs delayed insertion of penile prosthesis in patients with refractory priapism: a systematic review and meta-analysis
Abstract
Introduction: Refractory priapism, characterized by persistent and prolonged painful erections despite initial treatment maneuvers, can significantly impair erectile function secondary to ischemia-induced corporal tissue fibrosis. These patients will likely require subsequent penile prosthesis (PP) surgery to regain sexual activity, yet consensus regarding the optimal timing of implantation remains lacking. Objectives: To evaluate and compare the clinical outcomes associated with early vs delayed PP implantation in individuals with priapism-induced erectile dysfunction (ED). Methods: We included studies that focused on refractory priapism leading to ED and its management with PP implantation. We assessed cohort study bias with a risk-of-bias tool and case series bias with the modified Newcastle-Ottawa Scale. Pooled odds ratios (ORs) were calculated by a fixed-effect model. Results: We included 9 studies, comprising 4 cohort studies and 5 case series, involving a total of 278 patients. Total complications were higher in the delayed group (OR, 4.16; 95% CI, 2.77-6.26). Fibrosis was significantly more pronounced in the delayed group (OR, 118.18; 95% CI, 20.06-696.32). The odds of erosion, infections, and penile injury did not show statistically significant differences between the groups (OR, 2.52 [95% CI, 0.67-9.49], 0.89 [0.38-2.10], 1.83 [0.79-4.26], respectively). Patients’ satisfaction resulted in a pooled OR of 0.15 (95% CI, 0.04-0.49) in favor of the early PP insertion group. Conclusion: The results from this study favor an early approach to ED (within 30 days) following ischemic priapism. However, it is important to consider patients’ preferences, values, and psychological factors to make an informed decision.
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“The decision to proceed with penile prosthesis implantation was based on several factors indicating poor prognosis for spontaneous recovery:”
From Chlorpromazine-tadalafil interaction leading to refractory ischemic priapism and penile prosthesis implantation: a case report (2025) · cites this paper as [11]
In the citing paper
“For refractory cases or those presenting after prolonged duration (> 36 h), early penile prosthesis implantation may preserve penile length and address inevitable erectile dysfunction [10, 11].”
From Chlorpromazine-tadalafil interaction leading to refractory ischemic priapism and penile prosthesis implantation: a case report (2025) · cites this paper as [11]
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Rayyan-a web and mobile app for systematic reviews.
Ouzzani, M., Hammady, H., Fedorowicz, Z., & Elmagarmid, A. (2016) · Systematic Reviews · doi:10.1186/s13643-016-0384-4 · Cited by 26,092
ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions
Sterne, J. A., Hernán, M. A., Reeves, B. C., Savović, J., Berkman, N. D., Viswanathan, M., Henry, D., Altman, D. G., Ansari, M. T., Boutron, I., et al. (2016) · BMJ · doi:10.1136/bmj.i4919 · Cited by 20,329
Methodological quality and synthesis of case series and case reports
Murad, M. H., Sultan, S., Haffar, S., & Bazerbachi, F. (2018) · BMJ Evidence-Based Medicine · doi:10.1136/bmjebm-2017-110853 · Cited by 2,242
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Cited by
Arici, C., Basaranoglu, M., Cayan, S., Bozlu, M., & Akbay, E. (2025) · Basic and Clinical Andrology · doi:10.1186/s12610-025-00278-x
Metadata
- Authors
- Elmarasi, M., Alsaeedi, A., Elmakaty, I., Elsayed, B., Khalil, I. A., Aldeeb, M., Khalafalla, K., Al Kubaisi, K., Arafa, M., & Majzoub, A.
- Venue
- Sexual Medicine Reviews
- Publisher
- Oxford University Press (OUP)
- Published
- 2024-03-11
- Volume
- 12
- Issue
- 3
- Pages
- 528-536
- ISSN
- 2050-0513
- 2050-0521
- Cited by
- 13
- References
- 3
- Language
- en
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