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Priapism

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1. Treatments for priapism in boys and men with sickle cell disease. (Abstract)

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. This is an update of a previously published review.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

2020 Cochrane

2. Priapism

Priapism Priapism - 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

2018 BMJ Best Practice

3. Treatments for priapism in boys and men with sickle cell disease. (Full text)

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

2017 Cochrane PubMed abstract

4. A Systematic Review on Ischemic Priapism and Immediate Implantation: Do We Need More Data? (Abstract)

A Systematic Review on Ischemic Priapism and Immediate Implantation: Do We Need More Data? Ischemic priapism (IP) is the most common form of priapism. In cases of priapism persisting for >36 hours, conservative management usually fails, and the patients' erectile tissue will be inevitably compromised, resulting in corporal fibrosis, shortening of the penis, and refractory erectile dysfunction. In this subset of patients, early implantation of a penile prosthesis (PP) could be a solution (...) for both the priapic episode and the erectile dysfunction.To analyze the current literature with regard to the correlation between refractory ischemic priapism and immediate implantation of PP.An extensive literature research was conducted to retrieve studies focusing on immediate PP implantation in patients suffering from refractory ischemic priapism (RIP).We evaluated the functional outcomes of patients who have undergone the immediate insertion of a PP as treatment for an acute episode of IP

2020 Sexual medicine reviews

5. What is the effectiveness of non-surgical therapies in the treatment of ischemic priapism in patients with sickle cell disease? A systematic review on the management of ischaemic priapism in patients with sickle cell disease

What is the effectiveness of non-surgical therapies in the treatment of ischemic priapism in patients with sickle cell disease? A systematic review on the management of ischaemic priapism in patients with sickle cell disease Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate

2020 PROSPERO

6. Penile Prosthesis Implantation in Priapism. (Abstract)

Penile Prosthesis Implantation in Priapism. Priapism is defined as a full or partial erection lasting longer than 4 hours after sexual stimulation and orgasm or unrelated to sexual stimulation. The main goal of priapism management is to resolve the episode immediately to preserve erectile function and penile length. Corporal smooth muscle necrosis is likely to have already occurred, and medically refractory erectile dysfunction is expected in patients with a protracted episode. Penile (...) prosthesis implantation (PPI) in the early or late phase of priapism can restore erectile function.To review the literature on PPI in priapism.A PubMed search of all English-language articles published before 2017 was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement using the following search terms: penile prosthesis implantation, priapism, and corporal fibrosis. All publications reporting on PPI during or after priapism episodes were

2019 Sexual medicine reviews

7. Priapism in a patient with coronavirus disease 2019 (COVID-19): A case report. (Full text)

Priapism in a patient with coronavirus disease 2019 (COVID-19): A case report. Thromboembolic complications related to SARS-CoV-2 have been extensively reported. They include deep vein thrombosis, pulmonary embolism, ischemic stroke, and acute coronary syndrome. Penile thrombosis has not been reported as a thrombotic complication of SARS-CoV-2 infection with hypercoagulability. Here we describe a case of priapism as a thromboembolic complication in a patient with COVID-19 who recovered from

2020 American Journal of Emergency Medicine PubMed abstract

8. Priapism associated with pregabalin. (Abstract)

Priapism associated with pregabalin. Priapism is defined as a prolonged erection of the penis for at least 4 h without sexual stimulation. It may occur in all age groups. Drugs are the most common cause in adults. A 64-year-old male patient was admitted to the emergency department with painful erection that had lasted for 2 days without sexual stimulation. Our patient had used pregabalin for around 1 year due to neuropathic pain. The dose of the drug was increased as his pain scaled up recently (...) . Approximately 30 cc of dark blood was drained from the corpus cavernosum with an 18 Gauge needle in the emergency department. Cavernous blood aspiration and irrigation resulted in significant recovery and relief. We present this report of priapism associated with pregabalin as it is a rare case with insufficient number of studies in the literature.Copyright © 2019 Elsevier Inc. All rights reserved.

2020 American Journal of Emergency Medicine

9. Favourable multi-institutional experience with penoscrotal decompression for prolonged ischaemic priapism. (Abstract)

Favourable multi-institutional experience with penoscrotal decompression for prolonged ischaemic priapism. To report our multi-institutional experience using penoscrotal decompression (PSD) for the surgical treatment of prolonged ischaemic priapism (PIP).We retrospectively reviewed clinical records for patients with PIP treated with PSD between 2017 and 2020. Priapisms were confirmed as ischaemic based on clinical presentations and cavernosal blood gas abnormalities. Treatment with irrigation (...) and injection of α-agonists in all patients had failed prior to PSD. Patient characteristics, peri-operative variables and outcomes, and changes in International Index of Erectile Function (IIEF) scores were evaluated.We analysed 25 patients who underwent a total of 27 PSD procedures. The mean duration of priapism at initial presentation was 71.0 h. Irrigations and injections in all patients had failed, while corporoglanular shunt treatment in 48.0% of patients (12/25) had also failed prior to PSD

2020 BJU international

10. Multimodality magnetic resonance imaging for the diagnosis of high-flow priapism following a straddle injury: A case report. (Full text)

Multimodality magnetic resonance imaging for the diagnosis of high-flow priapism following a straddle injury: A case report. Priapism is a common urologic emergency, but high-flow penile priapism (HFP) caused by trauma is very rare. Therefore, HFP diagnosis and treatment are still not standardized.A 29-year-old man was admitted to the urology department of our hospital on August 01, 2019, due to "persistent penile erection caused by a straddle injury."On July 17, 2019, the patient underwent (...) , and the pseudoaneurysm, fistula, and priapism disappeared.Two months after surgery, sexual stimuli could normally cause penile erection, with normal hardness. The patient's sexual life returned to normal 3 months after surgery.Multimodality MRI is very effective in detecting high blood flow priapism. Its application would improve the clinical management of this ailment.

2020 Medicine PubMed abstract

11. Superselective embolization for high-flow priapism refractory to medical and surgical treatments. (Full text)

Superselective embolization for high-flow priapism refractory to medical and surgical treatments. This study aimed to report long-term outcome of superselective embolization in patients with high-flow priapism refractory to medical and surgical treatments.From August 2011 until July 2016, 14 patients with high-flow priapism refractory to local treatments were treated and their charts were retrospective reviewed. Clinical evaluation, color Doppler ultrasonography, arteriography and selective (...) embolization were performed. Follow up was performed in all patients. Fourteen men (18-63 years old) were enrolled, with priapism duration of 14 h to 28 days. Internal pudendal arteries or glutaea inferior arteriae were successfully embolized with gelatin sponge particles, polyvinyl alcohol particles or microcoils.Pseudoaneurysm in right femoral artery was found in one case after intervention. The follow-up 1 week later showed that 13 patients were in good condition, the priapism diminished 1-7 days (mean

2020 BMC Urology PubMed abstract

12. Using Artificial Intelligence to Predict Surgical Shunts in Men with Ischemic Priapism. (Abstract)

Using Artificial Intelligence to Predict Surgical Shunts in Men with Ischemic Priapism. Ischemic priapism is a urological emergency that requires prompt intervention to preserve erectile function. Characteristics that influence escalation to surgical intervention remain unclear. We identified factors and developed machine learning models to predict which men presenting with ischemic priapism will require shunting.We identified men with ischemic priapism admitted to the emergency department (...) of our large county hospital between January 2010 and June 2019. We collected patient demographics, etiology, duration of priapism prior to intervention, interventions attempted and escalation to shunting. Machine learning models were trained and tested using R to predict which patients require surgical shunting.A total of 334 encounters of ischemic priapism were identified. The majority resolved with intracavernosal phenylephrine injection and/or cavernous aspiration (78%). Shunting was required

2020 Journal of Urology

13. Clinical Outcomes of Periprocedural Antithrombotic Therapy in Ischemic Priapism Management. (Abstract)

Clinical Outcomes of Periprocedural Antithrombotic Therapy in Ischemic Priapism Management. Priapism is a urologic emergency consisting of a painful erection lasting greater than 4 hours; antithrombotic therapy (ATT) have recently been recommended as an adjunct in the treatment of ischemic priapism.To determine the short- and long-term outcomes of periprocedural ATT in the management of acute ischemic priapism.A retrospective review of patients seen at the University of California, San (...) Francisco, from 2008 to 2019 was carried out to identify those evaluated for acute priapism. Information regarding duration of priapism, etiology, treatment, periprocedural and postprocedural ATT type and dose, and follow-up data was collected.ATT use was the exposure of interest; outcome variables included priapism resolution, repeat episodes, long-term complications, and follow-up.70 patients with at least 1 detailed record of an acute priapism episode between 2008 and 2019 were identified. Of the 70

2020 Journal Of Sexual Medicine

14. Perspectives on Priapism Education in Emergency Medicine. (Abstract)

Perspectives on Priapism Education in Emergency Medicine. Priapism is a urologic emergency managed by both emergency medicine (EM) providers and urologists. Attitudes regarding its management and understanding of education of non-urology trainees in this area are poorly defined.The aim of this study was to describe attitudes toward priapism management among multiple stakeholders and define the current state of priapism education among EM residency programs.Surveys were developed and distributed (...) online to EM residency leadership, EM residents, and urology providers. Each solicited attitudes and preferences regarding independent priapism management by EM providers. EM residents were further queried about their educational and clinical experiences in priapism management, and EM residency leadership were surveyed about their educational curricula. Responses among all 3 groups were compared using Fisher's exact tests.Quantitative and descriptive responses were solicited regarding EM providers

2020 Journal Of Sexual Medicine

15. Are We Overstating the Risk of Priapism With Oral Phosphodiesterase Type 5 Inhibitors? (Abstract)

Are We Overstating the Risk of Priapism With Oral Phosphodiesterase Type 5 Inhibitors? Priapism is an adverse drug reaction (ADR) associated with phosphodiesterase type 5 inhibitors (PDE5is) in the treatment of erectile dysfunction.The purpose of this study was to identify the true data about PDE5i-associated priapism to properly counsel patients.We queried the U.S. Food and Drug Administration (FDA) Adverse Reporting System Public Dashboard to identify cases of drug-induced priapism among (...) medications commonly associated with priapism. Next, a systematic review and analysis of publications describing cases of drug-induced priapism were carried out.The main outome of this study is incidence of PDE5i-induced priapism.We found 411 cases of drug-induced priapism secondary to Viagra, Cialis, or Levitra reported to the Food and Drug Administration since 1998. Compared with PDE5is, drug-induced priapism was 2.6 (n = 1,065) and 2.0 times (n = 817) more commonly reported for second-generation

2020 Journal Of Sexual Medicine

16. Priapism

Priapism Guidelines on Priapism A. Salonia, I. Eardley, F . Giuliano, I. Moncada, K. Hatzimouratidis © European Association of Urology 2015 2 PRIAPISM - TEXT UPDATE MARCH 2015 TABLE OF CONTENTS PAGE 1. INTRODUCTION 4 1.1 Aim 4 1.2 Publication history 4 1.3 Panel composition 4 2. METHODS 4 3. THE GUIDELINE 5 3A ISCHAEMIC (LOW-FLOW OR VENO-OCCLUSIVE) PRIAPISM 5 3A.1 Epidemiology/aetiology/pathophysiology 5 3A.1.1 Conclusions on the epidemiology, aetiology and pathophysiology of ishaemic priapism (...) 6 3A.1.2 Classification 6 3A.1.3 Diagnostic evaluation 7 3A.1.3.1 History 7 3A.1.3.2 Physical examination 7 3A.1.3.3 Laboratory testing 7 3A.1.3.4 Penile imaging 8 3A.1.3.5 Recommendations for the diagnosis of ischaemic priapism 8 3A.1.4 Disease management 9 3A.1.4.1 First-line treatments 9 3A.1.4.1.1 Penile anaesthesia/systemic analgesia 9 3A.1.4.1.2 Aspiration ± irrigation with 0.90% w/v saline solution 9 3A.1.4.1.3 Aspiration ± irrigation with 0.90% w/v saline solution in combination

2015 European Association of Urology

17. Priapism from Recreational Intracavernosal Injections in a High-Risk Metropolitan Community. (Full text)

Priapism from Recreational Intracavernosal Injections in a High-Risk Metropolitan Community. Recreational use of intracavernosal injections (ICIs) is a high-risk behavior that involves sharing of these agents by men without physician regulation.To characterize the etiologies and outcomes of priapism at a Los Angeles metropolitan medical center to better understand patterns of usage of recreational ICIs and the public health implications of such practices.With institutional review board approval (...) , we retrospectively reviewed all cases of priapism presenting to the emergency room of a Los Angeles tertiary medical center from 2010 to 2018. We compared outcomes between patients who presented with priapism after recreational ICI and patients who presented with other etiologies.We describe patient characteristics, etiologies, and treatments of priapism at our institution.We identified 169 priapism encounters by 143 unique patients. Recreational ICIs accounted for 82 of the 169 priapism

2019 Journal Of Sexual Medicine PubMed abstract

18. Anatomic and Functional Outcome Following Distal Shunt and Tunneling for Treatment İschemic Priapism: A Single-Center Experience. (Abstract)

Anatomic and Functional Outcome Following Distal Shunt and Tunneling for Treatment İschemic Priapism: A Single-Center Experience. Ischemic priapism (IP) is a urologic emergency that requires early intervention. The main aim of IP treatment is to relieve the cavernosal pressure and provide erectile function.The aim of this study was to determine the correlation between preoperative risk factors (patient's age, duration of priapism, preoperative erectile function) and postoperative erectile (...) the occurrence of IP to surgery was 58 hours (range 24-240). In all cases, rapid resolution of the erection was achieved with the T-shunt ± tunneling procedure. In 1 patient, priapism recurred after 12 hours. Postoperative ED was reported by 16 (84.21%) patients, with degrees of mild, mild to moderate, and severe in 6, 1, and 9 of these cases, respectively. During the follow-up, the mean International Index of Erectile Function-5 (IIEF-5) score was 12.68 (range 5-23). Only 3 (15.78%) patients achieved

2019 Journal Of Sexual Medicine

19. Resolution of Acute Priapism in Two Children with Sickle Cell Disease who Received Nitrous Oxide. (Full text)

Resolution of Acute Priapism in Two Children with Sickle Cell Disease who Received Nitrous Oxide. Nitrous oxide (N2O) is an inhalational medication with few side effects that has anxiolytic, amnestic, potent venodilatory and mild-to-moderate analgesic properties commonly used in the emergency department (ED) setting. Priapism is a serious complication of sickle cell disease (SCD) with few treatment options and an adverse impact on quality of life. Although a 50:50 nitrous oxide/oxygen mix (...) is commonly used in France to enhance analgesia in patients with SCD and vaso-occlusive pain events (VOE) there are no reports of its use to treat priapism. We describe the effects of N2O for the treatment of acute priapism associated with SCD in a pediatric ED.This is a description of two patients with Hb-SS who presented to the ED with acute priapism that failed oral therapy. On each occasion N2O gas was utilized to help facilitate IV catheter placement.In each presentation the patients experienced

2019 Academic Emergency Medicine PubMed abstract

20. Priapism following erector spinae plane block for the treatment of a complex regional pain syndrome. (Abstract)

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

2019 American Journal of Emergency Medicine

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