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1 Pryor JP, Hehir M The management of priapism Br J Urol 1982;54:751 2 Winter CC, McDowell G Experience with 105 patients with priapism: update review of all aspects J Urol 1988;140:980 3 Ebbehoj J A new operation for priapism Scand J Plast Reconstr Surg 1974;8:241 4 Borrelli M, Mitre AI, Alfer Junior W, Denes FT, Wroclawski ER, Castilho LN, de Goes GM Surgical treatment of priapism using Al-Ghorab s technique Rev Paul Med 1983;101:27
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Guidelines for Research in Surgical Management of Priapism
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As can be seen from the cited literature, outside of case reports and, generally, small case series, little data exist on outcomes following shunt surgery While more data exists on outcomes from angioem-
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Priapism
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5 Quackles R Cure of a patient suffering from priapism by cavernos spongiosa anastomosis Acta Urol Belg 1964;32:5 6 Grayhack JT, McCullough W, O Cnor VI, Trippel O Venous bypass to control priapism Invest Urol 1964;1:509 7 Rees RW, Kalsi J, Minhas S, et al The management of low- ow priapism with the immediate insertion of a penile prosthesis BJU Int 2002;90:893 8 El-Bahnasawy MS, Dawood A, Farouk A Low- ow priapism: risk factors for erectile dysfunction BJU Int 2002;89:285 9 Kulmala RV, Lehtonen TA, Tammela TL Preservation of potency after treatment for priapism Scand J Urol Nephrol 1996;30:313 10 Chakrabarty A, Upadhyay J, Dhabuwala CB, et al Priapism associated with sickle cell hemoglobinopathy in children: long-term effects on potency J Urol 1996;155: 1419
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11 Nixon RG, O Connor JL, Milam DF Ef cacy of shunt surgery for refractory low ow priapism: a report on the incidence of failed detumescence and erectile dysfunction J Urol 2003;170:883 12 Lawani J, Aken Ova YA, Shittu OB Priapism: an appraisal of surgical treatment Afr J Med Med Sci 1999;28:21 13 Kaisary AV, Smith PJ Aetiological factors and management of priapism in Bristol 1978 1983 Ann R Coll Surg Engl 1986;68:252 14 Proca E Venous shunts in the treatment of acute thromboses of the cavernous body] Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir 1979;27:37 15 Richard F, Fourcade R, Le Guillou M, et al Etiological aspects and interest of early surgical management of priapism Eur Urol 1979;5:179
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Ejaculatory Disorders
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Chris G McMahon, Marcel Waldinger, David Rowland, Pierre Assalian, Young Chan Kim, Amado Bechara, and Alan Riley
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Ejaculatory dysfunction (EjD) is one of the most common male sexual disorders The spectrum of EjD extends from premature or rapid ejaculation, through delayed ejaculation to a complete inability to ejaculate, anejaculation, and includes retrograde ejaculation and painful ejaculation The sexual response cycle comprises four interactive, non-linear stages: desire, arousal, orgasm, and resolution In males, the fourth stage of orgasm is usually coincident with ejaculation, but represents a distinct cognitive and emotional cortical event Ejaculatory dysfunction is a disruption of the fourth stage of orgasm
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The physiology of ejaculation may be distinguished in the neurophysiology and neuropharmacology of ejaculation
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(peripheral) nervous system, and particularly the sympathetic nervous system, mediates ejaculation The mechanism of ejaculation is divided into two phases: emission and expulsion Emission: During emission, semen (eg sperm and seminal uids) is deposited into the posterior urethra through contractions of the vasa deferentia, seminal vesicles, and prostate At the same time, the internal sphincter of the urinary bladder is closed Expulsion (or true ejaculation): Emission is immediately followed by expulsion During expulsion, semen is forcefully propelled along the urethra and out of the penis by clonic contractions of striated muscles of the pelvic oor It should be noted that compared to erection, human ejaculation has, until recently, been poorly investigated [2] Although the neurophysiology of ejaculation is often described in absolute terms, a detailed, non-disputed physio anatomic description of the mechanism of human ejaculation has still to be produced [2]
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