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T‐shunt with or without tunnelling for prolonged ischaemic priapism

The T-shunt is indicated in cases of ischaemic priapism that are refractory to intracavernous injection of diluted α adrenergic medications. In ischaemic priapism of > 3 days’ duration, tissue death and oedema can obstruct blood flow from the proximal to distal corpus cavernosum; in these cases a T-shunt alone might be insufficient to restore penile circulation and consideration must be given to placing a bilateral T-shunt with tunnelling of each corpus cavernosum, using a rigid straight 20–24 F urethral sound or dilator.