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Priapism

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181. In vitro and in vivo animal models in priapism research. (Abstract)

In vitro and in vivo animal models in priapism research. Priapism is an enigmatic yet devastating clinical phenomenon. In the last two decades, the use of various animal models to study this disorder has dramatically advanced our understanding of this mysterious disorder.This report reviews various animal models used to study ischemic priapism and informs basic science researchers the broad view of priapism research.Retrospective review of pertinent literature from the last two decades via (...) PubMed search using the keywords "ischemic priapism" and "priapism model."  Findings on the animal models used in ischemic priapism research and its advantages and limitations.In vitro and in vivo animal models varying from dogs, cats, rabbits, rats to mice were used in priapism research. In vitro models included: (i) corpora cavernosa smooth muscle (CCSM) strip in organ bath; (ii) corporal tissue binding assay; (iii) CCSM cell culture under hypoxia/anoxia. In vivo models could be categorized as: (i

2011 Journal Of Sexual Medicine

182. High-flow priapism due to a malignant glomus tumor (glomangiosarcoma) of the corpus cavernosum. (Abstract)

High-flow priapism due to a malignant glomus tumor (glomangiosarcoma) of the corpus cavernosum. The major cause of non-ischemic high-flow priapism is post-traumatic vascular injury leading to an arterio-lacunar fistula. However, rare causes such as tumors may induce priapism. This is the first report of a malignant glomus tumor localized in the corpora cavernosa.The aim of this case is to emphasize the importance of the initial management of priapism and to suggest new tracks on the tests (...) to be performed when the usual exams are not sufficient.We report the case of a hypervascular penile tumor responsible for high-flow priapism as the first clinical symptom of a metastatic glomus tumor. The persistent penile tumescence was initially considered to be a stuttering priapism and treated using an oral α-adrenergic as no provoking event nor fistula was found. After a 2-week reluctance, a penile magnetic resonance imaging (MRI) was performed.The MRI showed a hypervascular lesion at the proximal part

2011 Journal Of Sexual Medicine

183. Priapism in hematological and coagulative disorders: an update. (Abstract)

Priapism in hematological and coagulative disorders: an update. Priapism is a true urological emergency that is typified by a persistent and painful erection. High-risk groups include patients with hematological or coagulative disorders; for example, those with sickle cell disease, leukemia or glucose-6-phosphate dehydrogenase deficiency. The diagnosis for priapism must be made urgently using patient history, physical examination and blood gas findings on corporal aspiration. Emergency (...) treatment is needed to avoid erectile dysfunction. However, in high-risk groups, prophylaxis must be encouraged. A number of prophylactic measures are emerging based on progress in the understanding of the pathophysiology of priapism in these particular patients. In this Review, priapism as it relates to hematological disorders is discussed, focusing on treatment and prophylaxis.

2011 Nature reviews. Urology

184. Clinical care of severe acute respiratory infections – Tool kit

status - Stiff neck - Hypothermia or fever - Headache • Hypoglycaemia YES NO YES Interagency Integrated Triage Tool: =12 years 2.2 Interagency Integrated Triage Tool 13 2. Screening, triage and initial approachInteragency Integrated Triage Tool: 3 sec • Weak and fast pulse • Heavy bleeding • Cold extremities • Any two of: - Lethargy - Sunken eyes - Very slow skin pinch - Drinks poorly OTHER • Any infant 39°C • High-risk trauma* • Threatened limb* • Acute testicular/scrotal pain or priapism • Snake

2020 WHO Coronavirus disease (COVID-19) Pandemic

186. Prescrire's ratings of new products and indications over the past 10 years

° 197); canakinumab in periodic fever syndromes (Prescrire Int n° 198); lopinavir + ritonavir oral solution for HIV-infected children from 14 days of age (Prescrire Int n° 198); everolimus in epilepsy associated with tuberous sclerosis complex (Prescrire Int n° 199); captopril oral solution (Rev Prescrire n° 418); etilefrine in priapism (Rev Prescrire n° 420); sofosbuvir alone or combined with ledipasvir for adolescents with chronic hepatitis C (Rev Prescrire n° 421); glecaprevir + pibrentasvir

2019 Prescrire

188. Covid-19: Clinical guide to surgical prioritisation during the coronavirus pandemic

open surgery Genital trauma/ amputation/ priapism (24hrs) Fournier’s gangrene Haematuria/ uncontrolled haemorrhage - causing haemodynamic instability and unresponsive to conservative Rx Trauma and orthopaedics Fractures - Open/ Neurovascular compromise/Sk in compromise/ Long Bone/Pelvis/Spi ne/Hip Septic arthritis - natural/prosth etic joint Dislocated joints Compartment syndrome ENT Airway obstruction - Cancer/Foreign body/Sepsis Neck trauma with vascular/visce ral/ airway injury Nasal/ear button

2020 NHS England

190. Blast crisis

focal neurological signs priapism confusion or stupor history of chronic myelogenous leukaemia (CML) exposure to ionising radiation exposure to alkylating chemotherapeutic agents Diagnostic investigations FBC and differential peripheral blood smear bone marrow aspiration and biopsy karyotype fluorescent in situ hybridisation quantitative PCR serum leukocyte alkaline phosphatase serum vitamin B12 T315I gene mutation test Treatment algorithm ACUTE ONGOING Contributors Authors Professor of Medicine

2018 BMJ Best Practice

191. Essential thrombocytosis

erythromelalgia splenomegaly arterial and venous thrombosis bleeding livedo reticularis age 50 to 70 years female sex no symptoms headache dizziness, lightheadedness, and paraesthesias syncope and seizures transient visual disturbances hepatomegaly priapism Unknown risk factors Genetic mutations (e.g., Janus kinase 2 [JAK2], calreticulin [CALR], or myeloproliferative leukaemia virus oncogene [MPL]) Diagnostic investigations FBC with peripheral smear iron panel CRP ESR fibrinogen bone marrow biopsy

2018 BMJ Best Practice

193. Male Sexual Dysfunction

and health among older adults in the United States. N Engl J Med, 2007. 357: 762. 2. Rosenberg, M.T., et al. Identification and diagnosis of premature ejaculation. Int J Clin Pract, 2007. 61: 903. 3. Tekgül, S., et al. European Association of Urology guidelines on Paediatric Urology. Edn. presented at the EAU Annual Congress London, 2017. 4. Montague, D.K., et al. American Urological Association guideline on the management of priapism. J Urol, 2003. 170: 1318. 5. Eland, I.A., et al. Incidence of priapism (...) in the general population. Urology, 2001. 57: 970. 6. Kulmala, R.V., et al. Priapism, its incidence and seasonal distribution in Finland. Scand J Urol Nephrol, 1995. 29: 93. 7. Furtado, P.S., et al. The prevalence of priapism in children and adolescents with sickle cell disease in Brazil. Int J Hematol, 2012. 95: 648. 8. Adeyoju, A.B., et al. Priapism in sickle-cell disease; incidence, risk factors and complications - an international multicentre study. BJU Int, 2002. 90: 898. 9. Emond, A.M., et al. Priapism

2019 European Association of Urology

194. Crizanlizumab, Voxelotor, and L-Glutamine for Sickle Cell Disease: Effectiveness and Value

significant acute complications such as acute chest syndrome, serious infections, stroke, renal necrosis, and priapism. 4 Chronic complications can emerge across multiple organs and include delayed puberty, avascular necrosis, skin ulcers, chronic pain, neurocognitive impairment, chronic kidney injury, pulmonary hypertension, cardiovascular disease, and can result in early mortality. 4 Resultant health care costs are high, with the total health system economic burden of SCD estimated at $2.98 billion per (...) unruly.” 6 We also heard patient testimony of young men being called perverts because they were experiencing priapism. The appearance of health, coupled with a lack of SCD awareness in patients’ broader communities, can lead to ignorant judgments of character. Patients who are unable to participate in their daily commitments at work or school due to unsurmountable fatigue, pain, or other complications, may be accused of laziness or be subject to bullying. Both children and their caregivers felt SCD

2020 California Technology Assessment Forum

195. Blast crisis

focal neurological signs priapism confusion or stupor history of chronic myelogenous leukaemia (CML) exposure to ionising radiation exposure to alkylating chemotherapeutic agents Diagnostic investigations FBC and differential peripheral blood smear bone marrow aspiration and biopsy karyotype fluorescent in situ hybridisation quantitative PCR serum leukocyte alkaline phosphatase serum vitamin B12 T315I gene mutation test Treatment algorithm ACUTE ONGOING Contributors Authors Professor of Medicine

2017 BMJ Best Practice

196. Diagnostic evaluation of sexual dysfunction in the male partner in the setting of infertility: a committee opinion

with lifestyle modi?cations, substituting alternative medications in place of those that can exacerbate ED, and moving on to PDE5i in patients who have organic causes of ED such as spinal cord injuries, radical pelvic surgery, severe atherosclerosis, or those who fail lifestyle therapy or desire rapid improvement in their ED. Typically,thesemenmaybestartedonaPDE5itrial,with appropriate counseling about risk of priapism (de?ned as an erection lasting longer than 4 hours). Contraindications for PDE5i use (...) include use of nitrates and inadequate cardiac reserve for sexual activity requiring clearance by a cardiolo- gist.Further,thesemedicationsshouldbeusedwithcautionin menonanalphablocker astheycancauseanunsafedropin bloodpressure.SideeffectsofPDE5iagentsincludeheadache, facial?ushing,muscleaches,nasalcongestion,abluetingein vision, dizziness, dyspepsia, and priapism. Typical doses of PDE5iaresildena?l50–100mg,tadala?l5–20mg,vardena?l 10–20 mg, and avana?l50–200 mg. All of these drugs are expensive, $10

2018 Society for Assisted Reproductive Technology

197. Erectile dysfunction: Scenario: Management of erectile dysfunction

Erectile dysfunction: Scenario: Management of erectile dysfunction Scenario: Management | Management | Erectile dysfunction | CKS | NICE Search CKS… Menu Scenario: Management Erectile dysfunction: Scenario: Management of erectile dysfunction Last revised in August 2019 Scenario: Management of erectile dysfunction From age 18 years onwards (Male). How should I manage a man with erectile dysfunction? Admit to hospital if there is priapism (persistent erection). Arrange referral: To urology (...) . Admission Priapism (persistent erection for longer than 4 hours) is a rare of phosphodiesterase-5 (PDE-5) inhibitors. Emergency treatment of priapism is needed to avoid permanent penile damage [ ; ]. Referral Referral to specialist care is necessary in men with problems that cannot be resolved in primary care, or in whom maximal treatment with PDE-5 inhibitors has proved ineffective. Specialist options include [ ; ; ; ; ]: Specific diagnostic investigations, including: Nocturnal penile tumescence

2018 NICE Clinical Knowledge Summaries

198. Erectile dysfunction: Phosphodiesterase-5 (PDE-5) inhibitors

on for further information. Left ventricular outflow obstruction (for example aortic stenosis and idiopathic hypertrophic subaortic stenosis). Anatomical deformation of the penis (for example angulation, cavernosal fibrosis, or Peyronie's disease). A predisposition to priapism (for example in sickle-cell disease, multiple myeloma, or leukaemia). In addition: Prescribe vardenafil with caution to elderly men and men with active peptic ulceration, bleeding disorders, or susceptibility to prolongation of QT (...) inhibitor if sudden visual impairment occurs. Sudden hearing loss. Advise the man to stop taking tadalafil and seek prompt medical attention if there is a sudden decrease or loss of hearing. Priapism (persistent erection). Warn the man to seek advice if he has an erection lasting longer than 4 hours. In addition: For sildenafil: Less common adverse effects include chest pain, drowsiness, dry mouth, epistaxis, fatigue, hypertension, hypoaesthesia, hypotension, painful red eyes, palpitation, tachycardia

2018 NICE Clinical Knowledge Summaries

199. Sickle cell disease: Scenario: Management - sickle cell crisis

[ ; ]. Other secondary care interventions include [ ; ]: The use of strong opiate analgesia to control pain. Incentive spirometry every 2 hours for people with acute chest syndrome. This helps to prevent the complications (infiltrates and atelectasis) of acute chest syndrome developing in children and adults with chest and back pain. Penile aspiration and irrigation with dilute epinephrine for men with acute priapism. This causes immediate detumescence (subsidence of erection) in most adolescent and men (...) with acute priapism. Etilefrine is also effective. Surgery is necessary when medical treatment fails. © .

2018 NICE Clinical Knowledge Summaries

200. Sickle cell disease: Scenario: Prevention of complications

on when and how to seek medical advice. Monitor the number of (and reason for) hospital admissions. In children, the aim is also to: Manage, monitor, and give support for any complications, such as stroke, lung disease, priapism, leg ulcers, gallstones, avascular necrosis, and eye complications. Monitor general health, including absence from school. Monitor development, nutrition, growth, and puberty. Review nocturnal enuresis in children older than 6 years. Document the size of the spleen. Check

2018 NICE Clinical Knowledge Summaries

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