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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. --- 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. --- 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 --- RESOURCES Dr. David Ralph article on use of MRI in management of priapism https://doi.org/10.1111/j.1464-410X.2... 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.2012.0... 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/s41443-019-01... Risk factors, diagnosis, and long-term erectile dysfunction outcomes in priapism https://doi.org/10.1038/s41443-025-01... Video Journal of Sexual Medicine (VJSM) on Penoscrotal decompression: A better method for priapism management https://www.vjsm.info/videos/all/peno... Surgical Management of Ischemic Priapism: what are the New Options? https://doi.org/10.1590/S1677-5538.IB... The Impact of Immediate Salvage Surgery on Corporeal Length Preservation https://doi.org/10.1016/j.juro.2018.0... --- The BackTable Urology Podcast is a resource for practicing urologists to learn tips, techniques, and practical advice from their peers in the field. Listen on BackTable.com/Urology or on the streaming platform of your choice. Get notified when new episodes drop! Subscribe to the BackTable Urology Podcast on your go-to podcast platform, and follow us on your social media platform of choice for regular updates. ► https://www.backtable.com/shows/urolo... #URO265 #erectiledysfunction #urology #menshealth