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Acta Medica Portuguesa 2003Priapism is a rare disease, characterized by a prolonged erection unrelated to sexual stimulus or desire. There are two distinct types of priapism with different...
Priapism is a rare disease, characterized by a prolonged erection unrelated to sexual stimulus or desire. There are two distinct types of priapism with different etiologies, pathophysiology, treatment and complications. A better understanding of these two clinical entities brought about, in recent years, some progress in their treatment. The authors make a retrospective analysis of the 17 cases of priapism diagnosed in this centre in the last twelve years. From this experience they review the standard approach to this disease, both diagnostic and therapeutic.
Topics: Adult; Aged; Decision Trees; Humans; Male; Middle Aged; Priapism; Retrospective Studies
PubMed: 15631854
DOI: No ID Found -
South African Medical Journal =... Sep 1968
Topics: Adult; Anticoagulants; Antifibrinolytic Agents; Chlordiazepoxide; Erectile Dysfunction; Hormones; Humans; Male; Methods; Middle Aged; Penis; Priapism; Steroids
PubMed: 5706630
DOI: No ID Found -
International Journal of Impotence... Dec 2001Heparin-induced priapism constitutes a special form of pharmaco-induced prolonged erection, but the pathophysiological principles are not yet definitely clear....
Heparin-induced priapism constitutes a special form of pharmaco-induced prolonged erection, but the pathophysiological principles are not yet definitely clear. Heparin-induced antiplatelet-antibodies may lead to the aggregation of thrombocytes and thus alter the penile blood flow leading to low-flow priapism. Alternatively, this condition may be explained by initial high-flow priapism that later turns into ischemic priapism. The question remains whether hemorrhage with subsequent organisation of the hematoma and late fibrosis constitutes a pathogenetic factor. Besides this pathogenetic discussion, this paper presents the differential diagnosis of priapism as well as diagnostic and therapeutic procedures.
Topics: Adult; Diagnosis, Differential; Heparin; Humans; Male; Priapism
PubMed: 11918254
DOI: 10.1038/sj.ijir.3900759 -
Postgraduate Medical Journal Feb 2006Priapism is a pathological condition of penile erection that persists beyond, or is unrelated to, sexual stimulation. Pathologically and clinically, two subtypes are... (Review)
Review
Priapism is a pathological condition of penile erection that persists beyond, or is unrelated to, sexual stimulation. Pathologically and clinically, two subtypes are seen-the high flow (non-ischaemic) variety and the low flow (ischaemic) priapism. The low flow type is more dangerous, as these patients are susceptible to greater complications and the long term recovery of erectile function is dependent on prompt and urgent intervention. Many of the causes of priapism are medical, including pharmacological agents, and as such, priapism should be considered as a medical and surgical emergency.
Topics: Adult; Age Factors; Algorithms; Child; Humans; Infant; Male; Middle Aged; Priapism; Recovery of Function
PubMed: 16461470
DOI: 10.1136/pgmj.2005.037291 -
The Journal of Sexual Medicine Dec 2014
Review
Topics: Clitoris; Female; Humans; Male; Priapism; Vulvar Diseases; Women's Health
PubMed: 25471141
DOI: 10.1111/jsm.12772 -
Andrologia 1999Recent advances in the understanding of erectile physiology have improved the prompt diagnosis and treatment of priapism. During initial assessment, the physician must... (Review)
Review
Recent advances in the understanding of erectile physiology have improved the prompt diagnosis and treatment of priapism. During initial assessment, the physician must distinguish between veno-occlusive low flow (ischemic) and arterial high flow (nonischemic) in order to choose the correct treatment option for each type of priapism. Patient history, physical examination, penile haemodynamics and corporeal metabolic blood quality assist the distinction between static and dynamic priapism. Normally, priapism is effectively treated with intracavernous vasoconstrictive agents or surgical shunting. However, when these two methods fail, subsequent treatment procedures are a matter for debate. Alternative options, such as intracavernous injection of methylene blue or selective penile arterial embolization, for the management of high and low flow priapism are described and a survey of current treatment modalities is presented.
Topics: Adult; Embolization, Therapeutic; Humans; Male; Methylene Blue; Priapism; Radiotherapy
PubMed: 10643520
DOI: 10.1111/j.1439-0272.1999.tb01451.x -
The Urologic Clinics of North America Aug 2013Shunt surgery is not universally successful toward detumescence, may lead to erectile dysfunction, and can make eventual penile prosthesis insertion difficult. Penile... (Review)
Review
Shunt surgery is not universally successful toward detumescence, may lead to erectile dysfunction, and can make eventual penile prosthesis insertion difficult. Penile prosthesis insertion during a priapistic episode alleviates ischemic pain, allows the patient to resume sexual function sooner, and prevents corporal scarring and shortening that makes subsequent prosthesis implantation difficult.
Topics: Acute Disease; Blood Gas Analysis; Humans; Ischemia; Male; Penis; Priapism; Prosthesis Implantation; Time Factors
PubMed: 23905940
DOI: 10.1016/j.ucl.2013.04.010 -
Pharmacotherapy Apr 2002Citalopram is a relatively new selective serotonin reuptake inhibitor (SSRI) that is becoming widely administered for the treatment of depression. Selective serotonin...
Citalopram is a relatively new selective serotonin reuptake inhibitor (SSRI) that is becoming widely administered for the treatment of depression. Selective serotonin reuptake inhibitors generally are associated with mild adverse sexual side effects; however, more serious reactions may occur. A 58-year-old man experienced priapism several hours after inadvertently taking three tablets of citalopram 20 mg, which he had mistaken for aspirin, in addition to his usual dosage of 20 mg twice/day. Three days later, he was hospitalized and treated with intracavernous phenylephrine. He ultimately required surgical intervention. Although the citalopram overdose appears to be largely responsible for the patient developing priapism, he also was taking tamsulosin 0.4 mg/day at bedtime for benign prostatic hyperplasia. As alpha1-blockers have been associated with priapism on rare occasions, tamsulosin may have been a contributing factor. The patient also had a history of priapism associated with trazodone. Health care professionals should vigilantly monitor patients who take citalopram in high dosages or in combination with other drugs associated with priapism. Patients who have a history of priapism with other drugs may be more susceptible to citalopram-associated priapism.
Topics: Citalopram; Depression; Humans; Male; Middle Aged; Priapism; Selective Serotonin Reuptake Inhibitors
PubMed: 11939691
DOI: 10.1592/phco.22.7.538.33672 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Apr 2022Priapism is a rare condition in children and the treatment algorithm is controversial in this age group. Herein, we report eight cases with low-flow priapism and our...
BACKGROUND
Priapism is a rare condition in children and the treatment algorithm is controversial in this age group. Herein, we report eight cases with low-flow priapism and our stepwise treatment approach in light of literature.
METHODS
We present a simple stepwise treatment for low-flow priapism including five steps. Step 1: Cold compress and analgesia while evaluation the priapism and its etiology. Step 2: Corporal aspiration and adrenaline infusion in the ward. Step 3: Modified Winter shunt in the same place. Step 4: Ketamine application and caudal block in the operating room. Step 5: Sapheno-cavernous (Grayhack) shunt. Eight cases with low-flow priapism were reviewed retrospectively. Symptoms, duration of tumescence, the interventions, and step that provide detumescence were recorded.
RESULTS
The mean age of patients was 8.5 years (1-17 y). The median time of the priapism before admission was 15 h (4-165 h). The etiological factors were sickle cell disease, hemodialysis due to chronic renal failure, and factor V Leiden mutation in three patients. Detumescence was achieved in one patient at Step 2, in two patients at Steps 3, 4, and 5, respectively. Rigidity of cavernous body was observed in one patient in long-term follow-up.
CONCLUSION
Low-flow priapism is a urological emergency that may cause erectile dysfunction. Treatment options should be selected according to a protocol that prevents time loss and avoids more invasive treatment in unnecessary situations. Our algorithm with simple nature and its steps from less invasive to more invasive procedures may be an alternative for the treatment of low-flow priapism.
Topics: Child; Erectile Dysfunction; Humans; Male; Pain Management; Priapism; Retrospective Studies
PubMed: 35485519
DOI: 10.14744/tjtes.2020.74670 -
Urologia Feb 2023Glans necrosis in association with priapism is very rare and its appropriate treatment is not known. There is a secondary cause in most cases. (Review)
Review
INTRODUCTION
Glans necrosis in association with priapism is very rare and its appropriate treatment is not known. There is a secondary cause in most cases.
CASE DESCRIPTION
We treated a 65-year-old man with priapism and glans necrosis using a closed shunt (Winter), continuous penile irrigation with normal saline, and heparin for 48 h and waited for the necrotic area to resolve spontaneously. The treatment outcome was much better compared to previous cases in whom open surgery, irrigation with pure normal saline, and/or resection of the necrotic area were performed.
CONCLUSION
In cases with priapism and glans ischemia, we recommend treating the condition with continuous covernose irrigation with heparinized saline and avoiding open surgery.
Topics: Male; Humans; Aged; Priapism; Saline Solution; Penis; Treatment Outcome
PubMed: 34965807
DOI: 10.1177/03915603211038287