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Priapism

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121. Priapism Induced by Boceprevir-CYP3A4 inhibition and Alpha-Adrenergic Blockade. Full Text available with Trip Pro

Priapism Induced by Boceprevir-CYP3A4 inhibition and Alpha-Adrenergic Blockade. A 44-year-old white man presented to the emergency department with a 3-day history of priapism requiring a surgically performed distal penile shunt. A drug-drug interaction is the suspected cause whereby CYP3A4 inhibition by boceprevir led to increased exposures of doxazosin, tamsulosin, and/or quetiapine, resulting in additional α-adrenergic blockade.

2013 Clinical Infectious Diseases

122. Second Pathways in the Pathophysiology of Ischemic Priapism and Treatment Alternatives. (Abstract)

Second Pathways in the Pathophysiology of Ischemic Priapism and Treatment Alternatives. To evaluate the early therapeutic alternatives such as bosentan, an endothelin receptor blocker, theophylline, an adenosin receptor blocker, and a nonselective phosphodiesterase enzyme inhibitor, zinc protoporphyrin (ZnPP), a heme oxygenase 1 inhibitor, for the therapy of ischemic priapism in the rat models.Twenty-four Sprague-Dawley rats were randomly divided into 4 equal groups: control group, ZnPP group (...) , bosentan group, and theophylline group. Erection was provided by vacuum constriction method and maintained for 4 hours for achieving the priapism in all groups. The rats in the control group were administered 1 mL/kg saline intraperitoneally (ip). The rats in group 2 were administered 25 mg/kg ZnPP ip. The rats in group 3 were administered 0.25 mg/kg bosentan ip. The rats in group 4 were administered 100 mg/kg theophylline ip. Six rats from each group were decapitated after 6 hours of drug

2013 Urology

123. Incidence of Priapism at Emergency Departments in the United States. (Abstract)

Incidence of Priapism at Emergency Departments in the United States. Priapism is a complex medical emergency that often requires prompt management. In this study, we examine the incidence of this condition in a United States population based setting, and assess patient and emergency department attributes associated with an increased likelihood of hospitalization.Emergency department visits with a primary diagnosis of priapism between 2006 and 2009 were abstracted from the Nationwide Emergency (...) Department Sample. Univariable and multivariable analyses were performed of patient and hospital characteristics of those admitted with priapism.Between 2006 and 2009 a weighted estimate of 32,462 visits to the emergency department for priapism was recorded in the United States, which represents a national incidence of 5.34 per 100,000 male subjects per year. The incidence of emergency department visits increased by 31.4% during the summer compared to the winter months. Overall 4,320 visits (13.3

2013 Journal of Urology

124. Salvage management of prolonged ischemic priapism: Al-Ghorab shunt plus cavernous tunneling with blunt cavernosotomy. (Abstract)

Salvage management of prolonged ischemic priapism: Al-Ghorab shunt plus cavernous tunneling with blunt cavernosotomy. The management of ischemic priapism (IP), especially in cases of prolonged IP (PIP), is enigmatic. The T-shaped shunt and intracavernous tunneling and the corporal "snake" maneuver have been reported as effective surgical procedures for PIP; however, management of the PIP that is refractory to these procedures is controversial.The present study is a report of two PIP cases

2013 Journal Of Sexual Medicine

125. Nationwide emergency department visits for priapism in the United States. (Abstract)

Nationwide emergency department visits for priapism in the United States. The epidemiology of priapism is not well characterized. A small number of studies based on inpatient data or small population samples have estimated the incidence to range from 0.34 to 1.5 cases per 100,000 males.To estimate the current epidemiology and impact on resource utilization of priapism in the United States (US).Rate of emergency department encounters for priapism in the US.Emergency department (ED) visits (...) for priapism were analyzed using discharge data from the Nationwide Emergency Department Sample (NEDS), Healthcare Cost and Utilization Project (HCUP). Priapism encounters were identified by ICD9 code. Priapism encounters were analyzed for patient and hospital characteristics, associated diagnoses, and hospital charge. Established weighting in the sample was used to calculate nationwide estimates.A total of 8,738 ED encounters for priapism were identified between 2006 and 2009 in the NEDS. This translated

2013 Journal Of Sexual Medicine

126. Testosterone replacement with 1% testosterone gel and priapism: no definite risk relationship. (Abstract)

Testosterone replacement with 1% testosterone gel and priapism: no definite risk relationship. Although testosterone replacement therapy (TRT) is the preferred treatment for hypogonadism, information for patients using testosterone includes too frequent or prolonged erections as a potential side effect.To assess the frequency and risk of priapism or related adverse events (AEs) in hypogonadal men treated with a 1% testosterone gel.Safety and tolerability data for AndroGel 1% were assessed (...) and receiving concomitant sildenafil 100 mg (N = 75). Postmarketing AndroGel pharmacovigilance reporting data from 2001 to 2011 was searched for events coded as priapism.The incidence of priapism and/or related symptoms reported as urogenital or reproductive system AEs.In the 283 men exposed to AndroGel 1% over the three trials, mean exposure ranged from 84 days to 149 days. No AEs described as priapism or related symptoms were reported in the three trials. In the postmarketing data, representing 40 million

2013 Journal Of Sexual Medicine

127. Standard operating procedures for priapism. (Abstract)

Standard operating procedures for priapism. To provide standard operating procedures for the diagnosis and management of priapism.Review of the literature.Reduction of priapism and preservation of erectile function.Priapism is a persistent penile erection that continues hours beyond, or is unrelated to, sexual stimulation. Priapism requires prompt evaluation and usually requires emergency management. There are two types of priapism: (i) ischemic (veno-occlusive or low flow), which is found (...) in 95% of cases, and (ii) nonischemic (arterial or high flow). Stuttering (intermittent) priapism is a recurrent form of ischemic priapism. To initiate appropriate management, the physician must determine whether the priapism is ischemic or nonischemic. Necessary diagnostic steps are an accurate history, physical examination, and cavernous blood gas analysis and/or color duplex ultrasonography of the corpora cavernosa. Management of ischemic priapism should achieve resolution as promptly as possible

2013 Journal Of Sexual Medicine

128. European Association of Urology Guidelines on Priapism. (Abstract)

European Association of Urology Guidelines on Priapism. Priapism is defined as a penile erection that persists beyond or is unrelated to sexual interest or stimulation. It can be classified into ischaemic (low flow), arterial (high flow), or stuttering (recurrent or intermittent).To provide guidelines on the diagnosis and treatment of priapism.Systematic literature search on the epidemiology, diagnosis, and treatment of priapism. Articles with highest evidence available were selected to form (...) the basis of these recommendations.Ischaemic priapism is usually idiopathic and the most common form. Arterial priapism usually occurs after blunt perineal trauma. History is the mainstay of diagnosis and helps determine the pathogenesis. Laboratory testing is used to support clinical findings. Ischaemic priapism is an emergency condition. Intervention should start within 4-6h, including decompression of the corpora cavernosa by aspiration and intracavernous injection of sympathomimetic drugs (e.g

2013 European Urology

129. The efficacy of the T shunt procedure and Intracavernous Tunnelling (snake manouver) for the management of refractory ischaemic priapism. (Abstract)

The efficacy of the T shunt procedure and Intracavernous Tunnelling (snake manouver) for the management of refractory ischaemic priapism. The current management of ischemic priapism that is refractory to conventional medical therapy is a form of shunt procedure that diverts blood away from the corpus cavernosum. We assessed the outcome of the T-shunt and intracavernous tunneling for the management of ischemic priapism.During a 36-month period 45 patients presented with prolonged ischemic (...) priapism. Patients were divided into subgroups according to the duration of priapism. All patients had an unsuccessful primary treatment, and underwent a T-shunt and intracavernous tunneling with cavernous muscle biopsies. All patients completed an IIEF-5 (International Index of Erectile Function-5) questionnaire preoperatively and 6 months postoperatively.Resolution of the priapism using a T-shunt and snake maneuver occurred in all patients with a priapism duration of less than 24 hours and in only 30

2013 Journal of Urology

130. Priapism in Sickle Cell Anemia

Priapism in Sickle Cell Anemia Priapism in Sickle Cell Anemia Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Priapism in Sickle Cell (...) Anemia Priapism in Sickle Cell Anemia Aka: Priapism in Sickle Cell Anemia From Related Chapters II. Epidemiology of Priapism in Sickle Cell Anemia: 89% by age 20 years old III. Management Duration: <2 hours s IV Fluids Do not transfuse for <4 hours Duration: 2-4 hours First Intracavernosal (1:1,000,000 dilution) or injection Other measures 10 mg (in repeated doses) Duration >4 hours Administer above measures if not already attempted Exchange transfusion (Risk of CVA symptoms) Urology indications

2015 FP Notebook

131. Priapism

Priapism Priapism Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Priapism Priapism Aka: Priapism From Related Chapters II (...) . Definitions Prolonged lasts longer than 4 hours Priapism lasts longer than 6 hours (associated with increased risk of permanent dysfunction) III. Pathophysiology Penile corpora cavernosa engorged Ventral corpora spongiosum and glans are not engorged (flaccid) IV. Precautions Priapism is a medical emergency Results in a permanent difficulty in obtaining future if left untreated Priapism in children can be due to underlying blood disorder Consider (may require leukopheresis) See V. Causes Ascending nerve

2015 FP Notebook

132. Effects of cigarette smoking on priapism induced by quetiapine: a case report Full Text available with Trip Pro

Effects of cigarette smoking on priapism induced by quetiapine: a case report Priapism is defined as an unwanted, prolonged, and painful erection which is unrelated to sexual stimulation. Some case studies suggest that priapism is an adverse effect of antipsychotic medications. In our case study a 30 year-old Iranian male with schizophrenia was experiencing recurrent priapism associated with quetiapine use. There are three interesting facts about this case: Firstly, the patient suffered (...) priapism after even low dose consumption of quetiapine. Secondly, this case had experienced priapism with risperidone, olanzapine, and even clozapine in the past, suggesting a possible pharmacodynamic interaction of antipsychotics and inner biological traits in this particular case. Thirdly, priapism induced by low dose quetiapine was resolved after cigarette smoking.

2012 DARU Journal of Pharmaceutical Sciences

133. Treatment of Priapism with Automated Red Cell Exchange and Hyperbaric Oxygen in an 11-year-old Patient with Sickle Cell Disease Full Text available with Trip Pro

Treatment of Priapism with Automated Red Cell Exchange and Hyperbaric Oxygen in an 11-year-old Patient with Sickle Cell Disease Priapism affects up to 50% of all males with sickle cell disease, and there is no standard treatment. Delayed and unsuccessful treatment leads to corporal fibrosis and impotence. It is therefore necessary to determine the best treatment methods for this complication in order to offer effective interventions to all affected patients. Herein we report an 11-year-old (...) patient with sickle cell disease that presented with priapism 72 h after onset, and was successfully treated with automated red cell exchange and hyperbaric oxygen following unsuccessful surgical and conventional interventions.

2012 Turkish Journal of Hematology

134. Priapism Lasting 19 Hours With Combined Use of Trazodone and Mirtazapine in a Patient With History of Successfully Tolerating Each Agent as Monotherapy Full Text available with Trip Pro

Priapism Lasting 19 Hours With Combined Use of Trazodone and Mirtazapine in a Patient With History of Successfully Tolerating Each Agent as Monotherapy 23469320 2013 06 04 2018 11 13 2155-7772 14 5 2012 The primary care companion for CNS disorders Prim Care Companion CNS Disord Priapism lasting 19 hours with combined use of trazodone and mirtazapine in a patient with history of successfully tolerating each agent as monotherapy. 10.4088/PCC.12l01349 PCC.12l01349 Sharma Taral R TR Carilion Clinic

2012 The Primary Care Companion for CNS Disorders

135. A Case of Priapism Associated With Rapid Increase in Risperidone Dose Full Text available with Trip Pro

A Case of Priapism Associated With Rapid Increase in Risperidone Dose 23469322 2013 06 04 2018 11 13 2155-7772 14 5 2012 The primary care companion for CNS disorders Prim Care Companion CNS Disord A case of priapism associated with rapid increase in risperidone dose. 10.4088/PCC.12l01365 PCC.12l01365 Refai Shariq S Department of Psychiatry, University of North Texas, John Peter Smith Health Network, Fort Worth, Texas, USA. Nakama Helenna H HH eng Journal Article 2012 09 20 United States Prim

2012 The Primary Care Companion for CNS Disorders

136. Chronic post-traumatic high-flow priapism treated with temporary gelatin sponge embolization Full Text available with Trip Pro

Chronic post-traumatic high-flow priapism treated with temporary gelatin sponge embolization We report the case of a 26-year-old man who presented with a non-painful priapism with a history of 3 months permanent erection after suffering a perineal trauma. An arteriocorporal fistula with a turbulent flow between the right cavernosal artery and the corpus cavernosum, conclusive for a high-flow priapism was initially detected by colour Doppler ultrasound. A superselective embolization with Gelatin (...) sponge was safe and effective to treat the high-flow priapism. The use of gelatin sponge resulted in a temporary embolization with long-term effect of penile detumescence and preservation of erectile function.

2012 Acta Radiologica Short Reports

137. Acute management of priapism in men. (Abstract)

Acute management of priapism in men. What's known on the subject? and What does the study add? Priapism is a rare event. However, various medications and medical conditions may increase the risk. Priapism can be ischaemic, non-ischaemic or stuttering. It is paramount to distinguish the type of priapism, as misdiagnosis may lead to significant morbidity. Ischaemic priapism represents a compartment syndrome of the penis and is therefore a medical emergency. A delay in management may significantly (...) affect future erectile function. Stuttering priapism represents recurrent subacute episodes of ischaemic priapism, which may lead to erectile dysfunction. Thus episodes must be minimised. Non-ischaemic priapism is not a medical emergency. However, misdiagnosis and injection with sympathomimetic agents can result in system absorption and toxicity. This review article provides a summary of the evaluation and management of priapism. Furthermore, a step by step flow chart is provided to guide

2012 BJU international

138. Priapism and sickle-cell anemia: diagnosis and nonsurgical therapy. (Abstract)

Priapism and sickle-cell anemia: diagnosis and nonsurgical therapy. Priapism describes a persistent erection lasting longer than 4 hours. Ischemic priapism and stuttering priapism are phenotypic manifestations of sickle-cell disease (SCD).To define the types of priapism associated with SCD, to address pathogenesis, and to recommend best practices.Literature review and published clinical guidelines.Priapism is a full or partial erection that persists more than 4 hours. There are three kinds (...) of priapism: ischemic priapism (veno-occlusive, low flow), stuttering priapism (recurrent ischemic priapism), and nonischemic priapism (arterial, high flow). Ischemic priapism is a pathologic phenotype of SCD. Ischemic priapism is a urologic emergency when untreated priapism results in corporal fibrosis and erectile dysfunction. The recommended treatment for ischemic priapism is decompression of the penis by needle aspiration and if needed, injection (or irrigation) with dilute sympathomimetic drugs

2012 Journal Of Sexual Medicine

139. Nonischemic priapism following penile tattooing. (Abstract)

Nonischemic priapism following penile tattooing. To our knowledge, here we report the first case of nonischemic priapism following penile tattooing.To report the first case of nonischemic priapism following penile tattooing.A case with tattooing-induced priapism is presented including subjective reporting, physical examination, and laboratory/radiologic evaluations.A 21-year-old man, presented with partially rigid penis of 3-month duration. On examination, the penis was half rigid (...) , with a tattoo on its dorsal surface, and a smaller tattoo on the glans (Figure 1). The patient initially stated that the tattoo had been created years ago, but later admitted that he had it created just before the occurrence of priapism. A traditional tattooist created the tattoo manually, using a handheld needle. Bleeding from deep penile tissue for several days complicated the tattooing. Known etiologies of priapism were investigated and ruled out. Specifically, perineal injury, leukemia, sickle cell

2012 Journal Of Sexual Medicine

140. Surgical management of ischemic priapism. (Abstract)

Surgical management of ischemic priapism. Surgery is a mainstay in the management of ischemic priapism. The surgical armamentarium for this condition has recently been expanded with the introduction of several innovative procedures.To review surgical procedures offered in the treatment of ischemic priapism and present a rational framework for their use.Medline searches through July 2010 were conducted using the terms priapism, surgery, shunt, and prosthesis.Expert opinion was based on review (...) of the medical literature related to this subject matter.A host of surgical procedures exist to address the genital complications of both acute presentations of ischemic priapism and its non-acute pathologic sequelae, which include penile deformities and erectile dysfunction. For the former, the intervention is used principally in an emergent context with the intention to relieve the acute pathologic effects of the condition and preserve erectile function. For the latter, the intervention is aimed generally

2012 Journal Of Sexual Medicine

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