Operative note 33 Advanced
Priapism shunts
What it does: operations to drain a stuck erection.
2026 FIRST
- Shunts are LAST resort.
- Over 4 h: aspirate the penis AND inject phenylephrine 100-500 mcg into the corpus. Repeat. Monitor BP. Try this before any surgery.
Quackels, penis-to-sponge
- Catheter in first. Protects the urethra.
- Cut at the peno-scrotal bend.
- Sew corpus walls together, 5/0.
- Cut both lengthways. Sew the edges together.
- Both sides if still erect.
Grayhack, saphenous vein
- Vein freed via groin crease cut.
- Tunnelled under skin to a corporal window.
- Sewn 5/0.
Barry, dorsal vein
- Deglove. Dorsal vein tied far, then joined to one corpus, 7/0.
- NO tight dressings after.
Stuttering type
- Oral phenylephrine. Self-injection 500 mcg.
- Or hormone switch, where ED is acceptable.
From the UroRef Operative Quick Guide.