Ep. 265 Managing Ischemic Priapism: Surgical Approaches & Outcomes with Dr. Maia VanDyke

Oct 14, 2025

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For patients with ischemic priapism, time to treatment can mean the difference between recovery and long-term dysfunction. In this episode, Dr. Maia VanDyke (UT Southwestern Medical Center) joins host Dr. Juan Andino (UCLA Health) for a high-yield discussion on managing this urologic emergency, from early recognition to advanced surgical options.
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SYNPOSIS
Together, they cover diagnosis, patient demographics, and traditional versus advanced interventions, with special attention to the role of penoscrotal decompression in prolonged ischemic priapism. The conversation highlights surgical techniques, postoperative care strategies, and patient counseling, including the hard but essential discussions about long-term erectile dysfunction risk. Drs. Andino and VanDyke also emphasize the importance of collaboration, encouraging general urologists to adopt these approaches while leaning on colleagues and centers of excellence for complex cases.
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TIMESTAMPS
00:00 - Introduction
02:18 - Understanding Priapism
07:52 - Diagnosis and Initial Management
16:51 - Advanced Management and Surgical Interventions
28:21 - Patient Retention Challenges
29:59 - Surgical Planning and Techniques
37:29 - Post-Operative Care and Patient Rehabilitation
44:13 - Future Directions in Research and Treatment
51:28 - The Role of General Urology
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RESOURCES
Dr. David Ralph article on use of MRI in management of priapism
https://doi.org/10.1111/j.1464-410X.2010.09368.x
Dr. Tom Lue article on corporal aspiration
https://doi.org/10.1038/nrurol.2009.50
Arthur “Bud” Burnett article on corporal tunneling
https://doi.org/10.1016/j.juro.2012.08.245
Allen “Al” Morey article on penoscrotal decompression erectile function outcomes
https://doi.org/10.1111/bju.15127
Survey on current management practices of ischemic priapism
https://doi.org/10.1038/s41443-019-0120-4
Risk factors, diagnosis, and long-term erectile dysfunction outcomes in priapism
https://doi.org/10.1038/s41443-025-01076-9
Video Journal of Sexual Medicine (VJSM) on Penoscrotal decompression: A better method for priapism management
https://www.vjsm.info/videos/all/penoscrotal-decompression-a-better-method-for-priapism-management
Surgical Management of Ischemic Priapism: what are the New Options? https://doi.org/10.1590/S1677-5538.IBJU.2024.0497
The Impact of Immediate Salvage Surgery on Corporeal Length Preservation
https://doi.org/10.1016/j.juro.2018.01.082