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PriapismPriapism - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Priapism Last reviewed: February 2019 Last updated: March 2018 Summary Pathological condition of persistent (>4 hours) penile erection in the absence of sexual excitation. Classified as ischaemic, non-ischaemic, or recurrent/stuttering. Diagnosis is based on history, clinical findings, and assessment of cavernous blood gases and/or colour duplex (...) ultrasound. Treatment of priapism should progress in a step-wise fashion. Ischaemic priapism warrants emergency management. First-line therapy includes therapeutic aspiration of blood with intracavernous injection of diluted alpha-adrenergic sympathomimetic agents. Surgical shunt procedures are performed in refractory cases. Non-ischaemic priapism is managed by observation. If a patient desires active treatment, selective cavernosal artery embolisation may be considered. Acute episodes of recurrent
Treatments for priapism in boys and men with sickle cell disease. Sickle cell disease comprises a group of genetic haemoglobin disorders. The predominant symptom associated with sickle cell disease is pain resulting from the occlusion of small blood vessels by abnormally 'sickle-shaped' red blood cells. There are other complications, including chronic organ damage and prolonged painful erection of the penis, known as priapism. Severity of sickle cell disease is variable, and treatment (...) is usually symptomatic. Priapism affects up to half of all men with sickle cell disease, however, there is no consistency in treatment. We therefore need to know the best way of treating this complication in order to offer an effective interventional approach to all affected individuals.To assess the benefits and risks of different treatments for stuttering (repeated short episodes) and fulminant (lasting for six hours or more) priapism in sickle cell disease.We searched the Cochrane Cystic Fibrosis
Re.: A prospective diary study of stuttering priapism in adolescents and young men with sickle cell anemia: report of an international randomized control trial; the Priapism in Sickle Cell Study (PISCES study). 22088730 2016 02 05 2018 12 01 1527-3792 185 5 2011 May The Journal of urology J. Urol. Re.: A prospective diary study of stuttering priapism in adolescents and young men with sickle cell anemia: report of an international randomized control trial; the Priapism in Sickle Cell Study (...) (PISCES study). 1837-8 10.1016/S0022-5347(11)60219-X Seftel Allen D AD eng Journal Article Comment United States J Urol 0376374 0022-5347 0 Adrenergic alpha-2 Receptor Agonists AIM IM J Androl. 2011 Jul-Aug;32(4):375-82 21127308 Adrenergic alpha-2 Receptor Agonists therapeutic use Anemia, Sickle Cell complications Humans Male Priapism drug therapy Stuttering complications 2011 11 18 6 0 2011 11 18 6 0 2016 2 6 6 0 ppublish 22088730 S0022-5347(11)60219-X 10.1016/S0022-5347(11)60219-X
Priapism following erector spinae plane block for the treatment of a complex regional pain syndrome. Erector spinae plane block (ESPB) is a novel block where local anesthetic is deposited between the erector spinae muscle and the underlying transverse process. Safety of this technique is emphasized in the majority of reports, but with a continued increase of its use, the number of related complications and side effects is likely to expand. We report the case of a patient treated with ESPB
The first case of neonatal priapism during hypothermia for hypoxic-ischemic encephalopathy and a literature review Neonatal priapism is a rare condition with only 26 described cases in literature since 1879. It is defined as a persistent penile erection occurring in the first 28 days of life, lasting at least 4 h that usually happens in the first days (from 2 to 12 days). It is a very different condition compared to the adult one because in newborns it is a relatively benign phenomenon
The Hemodynamic Effects of Intracavernosal Phenylephrine for the Treatment of Ischemic Priapism. We sought to evaluate whether the administration of phenylephrine (PE) at concentrations higher than those described in guidelines resulted in any significant changes in vital signs or impacted outcomes.After receiving institutional review board approval, we retrospectively reviewed the charts of patients presenting to our emergency department between May 1, 2014, and August 15, 2016, using (...) International Classification of Diseases, Ninth Edition and Internation Classification of Disease, Tenth Edition diagnosis codes for priapism. Treatment was reviewed, including corporal aspiration/irrigation, injection of PE, and shunt procedures. Vital signs were compared before and after treatment with PE. Baseline variables were explored with categorical data analysis (chi-squared tests, t-tests, and Mann-Whitney nonparametric tests). Where feasible, linear regression was used to evaluate
Posttraumatic High-Flow Nonischemic Priapism. Priapism is an uncommon disorder, and nonischemic priapism is seen less frequently in children, generally after trauma. Although it seems to be an advantage that urgent intervention is not required because of no cavernous ischemia, it is likely to be misdiagnosed because of the asymptomatic potential. We aimed to present a case of posttraumatic nonischemic priapism.
Daily tadalafil for the chronic phase of stuttering priapism: a case report. Recurrent (stuttering) ischemic priapism is a challenging clinical condition. Frequent recurrences result in frequent hospital admissions whereas treatment with a shunting procedure often results in erectile dysfunction.A 22-year-old man with stuttering idiopathic priapism developed erectile dysfunction (IIEF-5 score 12) following a Winter's shunt; he was given tadalafil, 5 mg/daily, for 6 months. This treatment (...) resulted in progressive restoration of erectile function in the 6 months following the shunt as well as in preventing recurrence of priapic episodes over a 24-month follow-up.This is the first report in literature of chronic treatment of stuttering priapism with a phosphodiesterase-5 inhibitor being able not only to prevent recurrent priapic episodes but also to restore erectile function following a Winter's shunt.
History of posttraumatic stress disorder · priapism · Dx? A 35-year-old African-American man, who was an active duty service member, presented to the Troop Medical Clinic with a 4-hour history of priapism. He had been taking sertraline 100 mg and prazosin 10 mg nightly for 4 months to treat his posttraumatic stress disorder (PTSD) with no reported adverse effects. These doses were titrated 2 months prior to presentation. The patient reported that he took his usual medication doses before bed
Emergency Management of Priapism in the United Kingdom: A Survey of Current Practice. Despite its importance, current practice in the emergency management of priapism in the United Kingdom is unknown.To evaluate current practice in the emergency management of priapism in the United Kingdom.All "full," "associate urological specialist," and "trainee" members of the British Association of Urological Surgeons (BAUS; leading membership-based organization for practitioners of urologic surgery (...) in the United Kingdom) were invited to participate in an online survey. Questions related to the emergency management of priapism, access to tertiary andrology services, and use of guidelines.Key outcome measures included frequency of encountered cases, access to specialist andrology support, confidence in key management steps, and use of current guidelines.213 of 1,304 (16.3%) eligible members completed the survey. Most reported managing 1 case annually (median = 1, range = 0->10). Only 7.0% transferred
Prognosis of men with penile metastasis and malignant priapism: a systematic review. Introduction: Metastases to the penis are rare, but can have severe consequences. The aim of this study was to systematically review the literature in order to gain more information on the presentation and prognosis of this metastatic disease. We reviewed the literature relating to all case reports, series and reviews about penile metastasis, from 2003 to 2013, through a Medline search. We identified 63 (...) articles and 69 patients. Metastases were located on the root (38.8%), the shaft (38.8%) or the glans (22.2%) of the penis. The diagnosis of penile metastasis was made after the primary cancer had been diagnosed. The most common presentation was a single small penile nodule. Ten patients reported priapism. The median survival time after diagnosis of penile metastasis was 10 months (range 6-18 months). A Kaplan-Meier analysis has shown that the patients presenting with priapism and those with metastases
Penoscrotal Decompression-Promising New Treatment Paradigm for Refractory Ischemic Priapism. For prolonged ischemic priapism, outcomes after distal shunt are poor, with only 30% success for priapic episodes lasting longer than 48 hours.To present a novel, glans-sparing approach of corporal decompression through a penoscrotal approach for cases of refractory ischemic priapism (RIP) after failed distal shunt procedures.We describe the technique and present our initial experience with penoscrotal (...) presented after a prolonged duration of priapism (median = 61 hours) after which the priapism was refractory to multiple prior treatments (median = 3, range = 1-75) including at least 1 distal shunt. MPP was inserted in 8 patients (57.1%), whereas the most recent 6 patients (42.9%) underwent PSD. All patients with PSD (6 of 6, 100%) were successfully treated with corporal decompression without additional intervention and noted immediate relief of pain postoperatively. In contrast, 37.5% of patients (3
Clitoral priapism due to distant clitoral metastasis of high-grade serous ovarian carcinoma: A case report and review of the literature •Cutaneous metastasis at the initial presentation of ovarian carcinoma is rare.•Clitoral metastasis in a gynecological malignancy can occasionally present as clitoral priapism.•Clitoral priapism can be treated with oral or intramuscular alpha blockade.
Malignant priapism in metastatic prostate cancer: A late event occurring early 29888172 2019 02 26 2214-4420 19 2018 Jul Urology case reports Urol Case Rep Malignant priapism in metastatic prostate cancer: A late event occurring early. 1-3 10.1016/j.eucr.2018.03.001 Barrett-Campbell Odeth O Department of Medicine, SUNY Downstate Medical Center, New York, United States. Petkovska Iva I Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, United States. Slovin Susan F SF (...) Genitourinary Oncology Service, Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan Kettering Cancer Center, New York, United States. eng Case Reports 2018 03 31 United States Urol Case Rep 101626357 2214-4420 Carboplatin/docetaxel Chromogranin A MRI Malignant priapism Prostate cancer Radiation 2018 02 15 2018 03 02 2018 6 12 6 0 2018 6 12 6 0 2018 6 12 6 1 epublish 29888172 10.1016/j.eucr.2018.03.001 S2214-4420(18)30062-7 PMC5991306 Rev Urol. 2011;13(2):90-4 21935340 Urol J. 2017 Jan
Recent advances in the management of priapismPriapism is an uncommon urological emergency that can lead to permanent impotence if prompt presentation and medical intervention is not performed. It is a breakdown of the usual physiological mechanisms controlling penile tumescence and detumescence, leading to a prolonged penile erection (>4 hours) that is unrelated to sexual stimulation. Currently, there are three accepted subtypes: ischaemic, non-ischaemic, and stuttering priapism, which is also (...) known as recurrent ischemic priapism. The aim of treatment is the immediate resolution of the painful erection and the preservation of cavernosal smooth muscle function in order to prevent cavernosal fibrosis, which can lead to penile shortening and permanent erectile dysfunction.
Priapism as the initial sign in hematologic disease: Case report and literature review Priapism is an uncommon sign and sometimes considered a diagnosis challenge into systemic disease; this is defined as ≥4 h continuous penile erection, without sexual stimulation. We state that this work has been reported in line with the SCARE criteria PRESENTATION OF CASE: A Mexican 52-year-old man was brought to the emergency room with priapism of six days of evolution. His medical history reported fatigue (...) and Philadelphia translocation t(9:22) (q34;q11.2) with P210 BCR-ABL1 fusion transcriber, patient was discharged with dasatinib for maintenance phase. Actually, he has a satisfactory evolution without relapses.The majority of reported cases shows the individual importance of hematological diseases in priapism as it is shown in the analysis of the literature of 10 years (2006-2016) that we made. It is imperative to consider the type of priapism, and the genetic and demographic patient aspects due to the early
Case â€” Temporary chemical castration in the management of recurrent priapism 29405906 2018 11 13 1911-6470 12 5 2018 May Canadian Urological Association journal = Journal de l'Association des urologues du Canada Can Urol Assoc J Case - Temporary chemical castration in the management of recurrent priapism. E265-E266 10.5489/cuaj.4875 Yi Yooni Y University of Michigan, Ann Arbor, MI, United States. Malaeb Bahaa B University of Michigan, Ann Arbor, MI, United States. eng Journal Article 2018 02
A Rare Case of Severe Idiopathic Stuttering Priapism in a Young Healthy Man Priapism, a persistent erection of the penis which has no association with sexual activity and lasts longer than four hours, is a urologic emergency. It can be classified into ischemic, nonischemic, and stuttering categories. The pathophysiology of stuttering priapism is not well understood; however, the dysregulation of nitric oxide and phosophodiesterase-5 (PDE5) has been put forward as a possible mechanism. A 35-year (...) -old male with a history of recurrent priapism presented with continuous penile erection for more than 48 hours. In the emergency room, penile aspiration and an intracavernous phenylephrine injection were attempted which did not help. Subsequently, a distal penile shunt was surgically created; however, the patient's symptoms still persisted. A second round of penile irrigation, aspiration, and an intracavernous phenylephrine injection were attempted, but it was not helpful. Finally, another