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Sexual Medicine Reviews Apr 2021Priapism is rare yet has the potential to inflict significant suffering on patients, often with lasting consequences such as erectile dysfunction, corporal muscle... (Review)
Review
INTRODUCTION
Priapism is rare yet has the potential to inflict significant suffering on patients, often with lasting consequences such as erectile dysfunction, corporal muscle necrosis, and a loss of sexual function. Although rare, it is a pathology that has received little focus in the literature, particularly that caused by malignancy, and it is in this form that the long-term prognosis becomes particularly poor.
AIM
This review looks at malignant priapism in detail moving from the etiology and pathogenesis through investigations and management to provide an up-to-date picture.
METHODS
In so doing, more than 30 articles are reviewed and examined from databases such as PubMed. Significant cases are provided as examples to provide a comprehensive review of a topic that receives little attention but can cause significant patient morbidity.
MAIN OUTCOME MEASURE
The main outcome measure was the use of aspiration, sympathomimetics, and surgery as the main treatment modalities and how each one is used with regard to both the underlying etiology of the priapism and also the prognosis. We look at the need for treatment and how that relates to quality of life and erectile function thereafter.
RESULTS
Solid tumor invasion-both primary and secondary-and hematologic malignancies represent the key etiologies of malignant priapism and aggressive treatment is needed. Recovery of erectile function can occur if intracavernosal phenylephrine is quickly administered or distal shunts are placed; however, the prognosis is often poor, and subsequent chemotherapy treatment is often required.
CONCLUSION
The importance of a clear history and examination cannot be understated, and although the prognosis is often poor, this review hopes to give clinicians better understanding to be able to recognize malignancy as a potential cause of priapism. Ralph O, Shroff N, Johnson MJ, et al. Malignancy: A Rare, Important and Poorly Understood Cause of Priapism. J Sex Med 2021; 9:312-319.
Topics: Erectile Dysfunction; Humans; Male; Neoplasms; Penile Erection; Priapism; Quality of Life
PubMed: 31902677
DOI: 10.1016/j.sxmr.2019.11.002 -
The Urologic Clinics of North America Nov 2007Priapism, a pathologic condition of persistent penile erection in the absence of sexual excitation, is a true erectile disorder. Although it may seem to affect only a... (Review)
Review
Priapism, a pathologic condition of persistent penile erection in the absence of sexual excitation, is a true erectile disorder. Although it may seem to affect only a small population of male individuals, it carries major significance. Possible complications of the disorder include penile fibrosis and permanent erectile dysfunction. All health care professionals should appreciate the importance of the disorder and be prepared to follow current principles of diagnosis and treatment to reduce or avert its complications.
Topics: Humans; Male; Priapism
PubMed: 17983902
DOI: 10.1016/j.ucl.2007.08.006 -
Nederlands Tijdschrift Voor Geneeskunde Jun 2018The term priapism describes erections of >4 hours that arise in the absence of or last well beyond sexual stimulation. Ischaemic priapism is the most common form and...
The term priapism describes erections of >4 hours that arise in the absence of or last well beyond sexual stimulation. Ischaemic priapism is the most common form and treatment success is strongly dependent on the duration of priapism. The aetiology is widely variable as a result of which several specialisms can be confronted with this condition. Over the past few years, urologists increasingly have to deal with patients who do not suffer from erectile dysfunction, but nevertheless use intracavernous injections with priapism as a result. These men are often reluctant to see a doctor due to shame and ignorance, which often leads to delayed treatment. According to current guidelines, early prosthesis implantation is recommended if the priapism lasted >36 hours. Treatment of stuttering priapism should be focused on prevention of subsequent episodes. Non-ischaemic priapism generally follows a mild course and can initially be approached conservatively.
Topics: Conservative Treatment; Emergency Medical Services; Humans; Male; Patient Selection; Priapism; Time-to-Treatment; Urologic Surgical Procedures, Male
PubMed: 30040312
DOI: No ID Found -
Expert Opinion on Pharmacotherapy Dec 2003Priapism is characterised by the presence of prolonged, often painful penile erection in the absence of a sexual stimulus. This rare condition has a range of... (Review)
Review
Priapism is characterised by the presence of prolonged, often painful penile erection in the absence of a sexual stimulus. This rare condition has a range of aetiologies, but is most common following self-administration of injection therapy for impotence. Priapism may be classified into high- and low-flow states. Low-flow priapism is an emergency ischaemic condition requiring prompt recognition and treatment to avoid devastating long-term complications of erectile dysfunction. Wide-ranging medical therapies are covered in this review. Diagnostic and treatment algorithms are suggested in light of the current available literature.
Topics: Humans; Male; Priapism; Vasoconstrictor Agents
PubMed: 14640926
DOI: 10.1517/14656566.4.12.2271 -
Urology Aug 2018
Topics: History, 15th Century; History, 16th Century; History, 17th Century; History, 18th Century; History, 19th Century; History, 20th Century; History, Ancient; History, Medieval; Humans; Male; Patient Care Management; Priapism
PubMed: 29729364
DOI: 10.1016/j.urology.2018.04.029 -
Current Urology Reports Nov 2006Priapism is defined as prolonged and persistent erection of the penis without sexual stimulation. This is a poorly understood disease process, and we have little... (Review)
Review
Priapism is defined as prolonged and persistent erection of the penis without sexual stimulation. This is a poorly understood disease process, and we have little information on the etiology and pathophysiology of this erectile disorder. Two main types of priapism exist: low-flow (ischemic) and high-flow (nonischemic) priapism. When the physician first diagnoses which type of priapism exists, distinguishing the type of priapic event is paramount in order to choose the correct treatment options. Until recently, we had not sufficiently understood the pathogenesis of this erectile disorder and therefore, could not effectively manage its pathologic consequences of erectile tissue damage and erectile dysfunction. In this review, the proposed pathogenesis of ischemic priapism is reviewed, and a survey regarding novel treatment modalities is given.
Topics: Humans; Male; Priapism
PubMed: 17052448
DOI: 10.1007/s11934-006-0061-6 -
The Nigerian Postgraduate Medical... 2020
Topics: Child; Emergency Medicine; Hospitals, Teaching; Humans; Male; Nigeria; Priapism; Universities; Urology
PubMed: 32687127
DOI: 10.4103/npmj.npmj_144_20 -
International Journal of Impotence... Dec 2003
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Andrologia Feb 2011Priapism is a pathological condition of a penile erection that persists beyond or is unrelated to sexual stimulation. Priapism is broadly classified into two types: (i)... (Review)
Review
Priapism is a pathological condition of a penile erection that persists beyond or is unrelated to sexual stimulation. Priapism is broadly classified into two types: (i) ischaemic priapism (veno-occlusive) (low-flow), (ii) nonischaemic priapism (arterial) (high-flow). We report the case of a newborn presenting with priapism on the first day of life and also review published data on the management and follow-up of this condition.
Topics: Erythrocyte Volume; Follow-Up Studies; Humans; Infant, Newborn; Ketamine; Male; Penis; Priapism
PubMed: 21219385
DOI: 10.1111/j.1439-0272.2009.01000.x -
The Journal of Sexual Medicine Jan 2013To provide standard operating procedures for the diagnosis and management of priapism. (Review)
Review
AIM
To provide standard operating procedures for the diagnosis and management of priapism.
METHODS
Review of the literature.
MAIN OUTCOME MEASURES
Reduction of priapism and preservation of erectile function.
RESULTS
Priapism is a persistent penile erection that continues hours beyond, or is unrelated to, sexual stimulation. Priapism requires prompt evaluation and usually requires emergency management. There are two types of priapism: (i) ischemic (veno-occlusive or low flow), which is found in 95% of cases, and (ii) nonischemic (arterial or high flow). Stuttering (intermittent) priapism is a recurrent form of ischemic priapism. To initiate appropriate management, the physician must determine whether the priapism is ischemic or nonischemic. Necessary diagnostic steps are an accurate history, physical examination, and cavernous blood gas analysis and/or color duplex ultrasonography of the corpora cavernosa. Management of ischemic priapism should achieve resolution as promptly as possible. Initial treatment is therapeutic aspiration with or without irrigation of the corpora. If this fails, intracavernous injection of sympathomimetic drugs is the next step. Surgical shunts should be performed if nonsurgical treatment has failed. The initial management of nonischemic priapism should be observation. Selective arterial embolization is recommended for the management of nonischemic priapism in patients who request treatment. The goal of management for a patient with recurrent (stuttering) priapism is prevention of future episodes.
CONCLUSION
Management of priapism has become increasingly successful as scientific understanding of the pathophysiology and molecular biology of priapism improves. The key to further success in the treatment of priapism is basic research of this uncommon but potentially devastating condition.
Topics: Clinical Protocols; Humans; Male; Penile Erection; Penis; Physical Examination; Practice Guidelines as Topic; Priapism
PubMed: 22462660
DOI: 10.1111/j.1743-6109.2012.02707.x