Đánh giá kết quả điều trị cương đau dương vật kéo dài tại Bệnh viện Hữu nghị Việt Đức và Bệnh viện Đại học Y Hà Nội giai đoạn 2019–2024

Priapism is a rare, urgent urological condition characterized by a persistent penile erection unrelated to sexual stimulation, resulting from an imbalance in cavernosal blood flow. Untreated, it can lead to severe and irreversible penile fibrosis and erectile dysfunction. Given its profound impact on long-term physiological, psychological, and quality-of-life outcomes, understanding effective management strategies is paramount. This study aims to evaluate the treatment outcomes of patients with priapism managed at Viet Duc University Hospital and Hanoi Medical University Hospital from 2019 to 2024, providing crucial insights into optimizing clinical practice in Vietnam's healthcare context.

Urologists, general surgeons, emergency physicians, medical researchers, and healthcare policy-makers involved in the diagnosis and treatment of priapism.

This study conducted a prospective cross-sectional descriptive analysis of treatment outcomes for 32 patients diagnosed with priapism at Viet Duc University Hospital and Hanoi Medical University Hospital between 2019 and 2024. The cohort comprised 25 cases of ischemic priapism (78.1%) and 7 cases of non-ischemic priapism (21.9%). Key findings reveal significant differences between the two types. Patients with ischemic priapism presented with a significantly shorter time from onset to treatment (19.8 ± 6.4 hours vs. 139.1 ± 8.7 hours, p < 0.001) and achieved detumescence much faster (4.8 ± 0.5 hours vs. 38.4 ± 4.9 hours, p < 0.001). The primary treatment for ischemic cases was shunting (84%), while non-ischemic cases were predominantly managed with selective arterial embolization (71.4%). At one-month follow-up, most patients reported minimal or no pain, with a low recurrence rate (12.5%) and no instances of corporal necrosis or severe complications like infection or deformity.

However, at 3-6 months post-treatment, erectile dysfunction was prevalent in 78.1% of patients, with the ischemic group experiencing a significantly higher rate of severe dysfunction (40% vs. 14.3%) and lower mean IIEF-5 scores (12.5 ± 4.3 vs. 18.2 ± 3.1, p = 0.004). The ischemic group also exhibited a trend towards higher rates of psychological disorders (stress 40%, anxiety 32%, depression 24%), although these differences were not statistically significant. Overall quality of life was impaired in 65.6% of patients, yet 75% reported satisfaction with treatment outcomes. This research underscores that timely and appropriate intervention for priapism is critical. Selecting the correct treatment technique, tailored to the specific type of priapism (ischemic priapism vs. non-ischemic priapism), significantly enhances long-term physiological, psychological, and quality-of-life outcomes, highlighting the importance of early diagnosis and differentiated management strategies.