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The Journal of Sexual Medicine Nov 2010Penile erection is a hemodynamic process, which results from increased flow and retention of blood in the penile organ due to the relaxation of smooth muscle cells.... (Review)
Review
INTRODUCTION
Penile erection is a hemodynamic process, which results from increased flow and retention of blood in the penile organ due to the relaxation of smooth muscle cells. Adenosine, a physiological vasorelaxant, has been shown to be a modulator of penile erection.
AIM
To summarize the research on the role of adenosine signaling in normal penile erection and erectile disorders.
MAIN OUTCOME MEASURES
Evidence in the literature on the association between adenosine signaling and normal and abnormal penile erection, i.e., erectile dysfunction (ED) and priapism.
METHODS
The article reviews the literature on the role of endogenous and exogenous adenosine in normal penile erection, as well as in erectile disorders namely, ED and priapism.
RESULTS
Adenosine has been shown to relax corpus cavernosum from various species including human in both in vivo and in vitro studies. Neuromodulatory role of adenosine in corpus cavernosum has also been demonstrated. Impaired adenosine signaling through A(2B) receptor causes partial resistance of corpus cavernosum, from men with organic ED, to adenosine-mediated relaxation. Increased level of adenosine has been shown to be a causative factor for priapism.
CONCLUSION
Overall, the research reviewed here suggests a general role of exogenous and endogenous adenosine signaling in normal penile erection. From this perspective, it is not surprising that impaired adenosine signaling is associated with ED, and excessive adenosine signaling is associated with priapism. Adenosine signaling represents a potentially important diagnostic and therapeutic target for the treatment of ED and priapism.
Topics: Adenosine; Humans; Impotence, Vasculogenic; Male; Penile Erection; Penis; Priapism; Receptors, Cyclic AMP; Receptors, Neurotransmitter; Receptors, Purinergic P1; Risk Factors; Signal Transduction; Vasodilator Agents
PubMed: 19889148
DOI: 10.1111/j.1743-6109.2009.01555.x -
Urologia Internationalis 2021Infection by COVID-19, being a respiratory disease caused by SARS-CoV-2, can predispose to arterial and venous thrombotic disease, in response to excessive inflammation,...
Infection by COVID-19, being a respiratory disease caused by SARS-CoV-2, can predispose to arterial and venous thrombotic disease, in response to excessive inflammation, platelet activation, endothelial dysfunction, and venous stasis. During the COVID-19 pandemic period, the technological and resource availability for the care of these patients with thrombotic disease is critical, marking a factor of morbidity and poor prognosis in these cases. We describe a case of priapism in a patient with COVID-19, during the course of systemic inflammatory response syndrome and respiratory distress syndrome with a procoagulant state, seeking to relate the pathophysiological factors of ischemic priapism in patients with infection with SARS-Cov-2.
Topics: Adult; COVID-19; Fatal Outcome; Humans; Ischemia; Male; Penile Erection; Penis; Priapism; Regional Blood Flow
PubMed: 34107472
DOI: 10.1159/000514421 -
Asian Journal of Andrology Jan 2013Priapism is a rare condition that involves persistent penile erection for greater than 4 h. Distinct variants exist, each with unique characteristics. Ischemic priapism... (Review)
Review
Priapism is a rare condition that involves persistent penile erection for greater than 4 h. Distinct variants exist, each with unique characteristics. Ischemic priapism is a painful medical emergency that may occur as a result of veno-occlusion leading to hypoxia and tissue death. Recurrent bouts of ischemic priapism, or stuttering priapism, require treatment for individual attacks as well as long-term prevention. Non-ischemic priapism is associated with trauma and may be managed conservatively. Recent advances into the pathophysiology of priapism have allowed the development of treatment algorithms that specifically target the mechanisms involved. In this review, we outline the basics of smooth muscle contraction and describe how derangement of these pathways results in priapism. A pathophysiological approach to the treatment of priapism is proposed with duration-based algorithms presented to assist in management.
Topics: Algorithms; Disease Management; Humans; Ischemia; Male; Muscle Contraction; Muscle, Smooth; Penile Erection; Penis; Priapism
PubMed: 23202699
DOI: 10.1038/aja.2012.83 -
BMJ Case Reports Apr 2022Priapism is an urgent urological condition with varied aetiology that may be classified as low flow (ischaemic) or high flow (non-ischaemic). Diagnosis requires detailed...
Priapism is an urgent urological condition with varied aetiology that may be classified as low flow (ischaemic) or high flow (non-ischaemic). Diagnosis requires detailed clinical history and examination combined with appropriate investigations such as cavernosal blood gas sampling and penile Doppler ultrasound. In the case of high-flow priapism CT angiography can identify sources of abnormal arterial blood flow and cases may be managed conservatively, with surgery or through arterial embolisation. We detail a case of a young man presented 2 weeks after perineal trauma with high-flow priapism with an equivocal penile Doppler ultrasound. Cavernosal blood gas sampling was consistent with arterial blood and CT angiography was performed showing an arteriovenous fistula. The patient was then successfully managed with arterial embolisation resulting in detumescence and preserving sexual function.
Topics: Angiography; Arteriovenous Fistula; Embolization, Therapeutic; Humans; Male; Penis; Priapism
PubMed: 35440436
DOI: 10.1136/bcr-2022-249513 -
Diseases (Basel, Switzerland) Feb 2023Priapism is a very rare complication of malignancy and is usually accompanied by locally advanced or widely metastatic disease. We describe a case of priapism arising in...
BACKGROUND
Priapism is a very rare complication of malignancy and is usually accompanied by locally advanced or widely metastatic disease. We describe a case of priapism arising in a 46-year-old male with localised rectal cancer that was responding to therapy.
CASE PRESENTATION
This patient had just completed two weeks of neoadjuvant, long-course chemoradiation when he presented with persistent painful penile erection. Assessment and diagnosis were delayed for more than 60 h, and although a cause could not be determined from imaging, a near complete radiological response of the primary rectal cancer was seen. His symptoms were refractory to urologic intervention and were associated with extreme psychological distress. He re-presented shortly thereafter with extensively metastatic disease in the lungs, liver, pelvis, scrotum, and penis; additionally, multiple venous thromboses were identified, including in the dorsal penile veins. His priapism was not reversible and was associated with a considerable symptom burden for the remainder of his life. His malignancy did not respond to first-line palliative chemotherapy or radiation, and his clinical course was further complicated by obstructive nephropathy, ileus, and genital skin breakdown with a suspected infection. We initiated comfort measures, and he ultimately died in hospital less than five months after his initial presentation.
CONCLUSION
Priapism in cancer is usually related to tumour infiltration of the penis and corporal bodies resulting in poor venous and lymphatic drainage. The management is palliative and can include chemotherapy, radiation, surgical shunting, and potentially penectomy; however, conservative penis-sparing therapy may be reasonable in patients with limited life expectancy.
PubMed: 36810548
DOI: 10.3390/diseases11010034 -
Urology Case Reports Jan 2022Priapism is defined as a whole or partial penile erection that persists for more than 4 hours without stimulation. Hematologic disorders are a significant risk factor...
Priapism is defined as a whole or partial penile erection that persists for more than 4 hours without stimulation. Hematologic disorders are a significant risk factor for ischemic priapism. Here, we report a case of priapism due to chronic myelocytic leukemia. This is rare considering that the epidemiology of priapism in hematologic malignancies includes only 1% of patients with chronic myelocytic leukemia. Priapism has a relatively high complication rate, and management generally focuses on prompt treatment. Hematologic screening should be performed to rule out the possibility of these disorders that could underlie priapism.
PubMed: 34840959
DOI: 10.1016/j.eucr.2021.101946 -
British Medical Journal Oct 1970
Topics: Blood Pressure; Chlorpromazine; Humans; Male; Phenothiazines; Priapism; Schizophrenia
PubMed: 5471763
DOI: 10.1136/bmj.4.5727.118-a -
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 -
Journal of Ultrasound Dec 2021Priapism is a prolonged penile tumescence or erection unrelated to sexual stimulation that lasts more than 6 h. High-flow priapism is a rare condition usually due to a...
Priapism is a prolonged penile tumescence or erection unrelated to sexual stimulation that lasts more than 6 h. High-flow priapism is a rare condition usually due to a perineal trauma with the formation of an arterio-cavernosal fistula between a cavernosal artery and the lacunar spaces of the penis. High-flow priapism is usually diagnosed by clinical examination and color Doppler ultrasound, and the gold standard therapeutic management is represented by digital subtraction angiography. We report a case of a young patient with high-flow priapism after a motorcycle blunt perineal trauma, examining in detail the specific color Doppler ultrasound findings, the diagnostic workup and the therapeutic management.
Topics: Arteries; Embolization, Therapeutic; Humans; Male; Penis; Priapism; Ultrasonography, Doppler, Color
PubMed: 32198630
DOI: 10.1007/s40477-020-00449-8 -
Federal Practitioner : For the Health... Jul 2022Priapism is a disorder that occurs when the penis maintains a prolonged erection in the absence of appropriate stimulation. Conditions that result in hypercoagulable...
BACKGROUND
Priapism is a disorder that occurs when the penis maintains a prolonged erection in the absence of appropriate stimulation. Conditions that result in hypercoagulable states and hyperviscosity are associated with ischemic priapism. COVID-19 is increasingly associated with coagulopathy. To date, there are 6 reported cases of priapism occurring in patients with COVID-19, 5 occurring in the setting of critical illness.
CASE PRESENTATION
We present a case of ischemic priapism which we suspect resulted from COVID-19-associated coagulopathy in a patient without severe COVID-19 presentation.
CONCLUSIONS
Although there have been only a handful of reported cases of COVID-19-associated coagulopathy leading to ischemic priapism, it is possible that the true incidence is much higher. While our case highlights the importance of considering COVID-19 infection in the differential diagnosis of ischemic priapism, more research is needed to understand incidence and definitively establish a causative relationship.
PubMed: 36425347
DOI: 10.12788/fp.0286