(838) Ischemia Duration and Surgical Approach as Risk Factors for Erectile Dysfunction Following Priapism in Brazilian Hospital

Introduction Ischemic priapism is an urological emergency characterized by an acute compartment syndrome of the penis, which sometimes requires surgical intervention. Its prognosis is highly dependent on the time elapsed between symptom onset and medical treatment. Erectile dysfunction (ED) is one of the most significant and feared complications of this condition, frequently associated with the duration of ischemia. Previous studies report a post-surgical ED prevalence of up to 73.5%. However, the influence of the type of procedure and the duration of priapism on the occurrence of ED remains poorly understood in the literature. Objective To investigate whether the type of surgical procedure and the duration of priapism influence the risk of erectile dysfunction. Methods This retrospective study analyzes medical records from an urological referral hospital between 2016 and 2025. Patients were categorized according to the type of surgical procedure: Drainage (n = 27), Winter (n = 10), Al-Ghorab (n = 9), Corporal Snake (n = 2), and Ebbehoj (n = 1). The presence of erectile dysfunction (ED) was assessed through objective questions regarding symptoms during follow-up consultations. Statistical analyses were performed using RStudio software, with a significance level set at 5% (p < 0.05). Results Data from 49 patients who underwent different surgical interventions for priapism treatment were analyzed. Analysis of variance (ANOVA) showed no statistically significant difference between groups regarding age (F = 0.95; p = 0.444), with a minimum age of 8 years, a maximum of 69 years, and a mean of 34 years. The duration of priapism varied across procedures, with mean times of 48 hours for Ebbehoj, 66 hours for Corporal Snake, 68 hours (±33.6) for Winter, 72 hours (±88.5) for Drainage, and 102 hours (±101.84) for Al-Ghorab. In the overall sample, the minimum observed duration was 5 hours, the maximum was 360 hours, with a median of 66 hours. Comparison of priapism duration across procedures using the Kruskal–Wallis test revealed no statistically significant difference (χ2 = 2.52; df = 4; p = 0.6411). The overall frequency of erectile dysfunction complaints was 55.1%, varying by procedure type: 44% for Drainage, 50% for Corporal Snake, 60% for Winter, 77% for Al-Ghorab, and 100% for Ebbehoj. However, the association analysis between procedure type and presence of erectile dysfunction, initially assessed using Pearson’s chi-square test, was inconclusive, and Fisher’s exact test indicated no significant association (p = 1.00). Adjusted logistic regression did not identify any association between procedure type or priapism duration and the risk of erectile dysfunction (p = 1; null coefficients; high standard errors). Conclusions In this sample, it was not possible to establish a statistically significant association between priapism duration or the type of surgical procedure and the occurrence of erectile dysfunction. Disclosure No