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Priapism

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

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

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

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. (PubMed)

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. European Association of Urology Guidelines on Priapism. (PubMed)

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

125. Long-term phosphodiesterase 5 inhibitor therapy for recurrent priapism: a systematic review and meta-analysis

Long-term phosphodiesterase 5 inhibitor therapy for recurrent priapism: a systematic review and meta-analysis 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. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation

2016 PROSPERO

126. Chronic post-traumatic high-flow priapism treated with temporary gelatin sponge embolization (PubMed)

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.

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2012 Acta Radiologica Short Reports

127. Treatment of Priapism with Automated Red Cell Exchange and Hyperbaric Oxygen in an 11-year-old Patient with Sickle Cell Disease (PubMed)

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.

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2012 Turkish Journal of Hematology

128. A Case of Priapism Associated With Rapid Increase in Risperidone Dose (PubMed)

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

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2012 The Primary Care Companion for CNS Disorders

129. Priapism Lasting 19 Hours With Combined Use of Trazodone and Mirtazapine in a Patient With History of Successfully Tolerating Each Agent as Monotherapy (PubMed)

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

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2012 The Primary Care Companion for CNS Disorders

130. Effects of cigarette smoking on priapism induced by quetiapine: a case report (PubMed)

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.

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2012 DARU Journal of Pharmaceutical Sciences

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. 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

133. Conversion of low-flow to high-flow priapism: a case report and review (CME). (PubMed)

Conversion of low-flow to high-flow priapism: a case report and review (CME). Priapism is defined as an erection lasting greater than 4 hours. It is grouped into three subtypes: ischemic (low flow), nonischemic (high flow), and stuttering priapism. We present an interesting case and review of the conversion from a low-flow to a high-flow priapism. This conversion has rarely been reported. It has resulted from treatment of low-flow priapism with minimally invasive procedures including injection

2012 Journal Of Sexual Medicine

134. Nonischemic priapism following penile tattooing. (PubMed)

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

135. Surgical management of ischemic priapism. (PubMed)

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

136. Priapism and sickle-cell anemia: diagnosis and nonsurgical therapy. (PubMed)

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

137. New insights into the pathophysiology of sickle cell disease-associated priapism. (PubMed)

New insights into the pathophysiology of sickle cell disease-associated priapism. Priapism is defined as an erectile disorder, in which erection persists uncontrollably without sexual purpose. The precise mechanisms involved in the development of sickle cell disease-associated priapism are ill defined.To summarize the recent developments that increase our understanding of the molecular mechanisms of priapism.This article reviews the literature (Medline search 2000-2010) that relates the key (...) molecular signaling pathways that contribute to the development of priapism associated with sickle-cell disease. It focuses on basic science investigations using multiple animal models.The reader will be informed of the most current research regarding the role of endothelial nitric oxide synthase, phosphodiesterase type 5 (PDE5), adenosine, RhoA/Rho-kinase (ROCK), and opiorphins in the pathophysiology of priapism.New concepts in the field of priapism research suggest that priapism often results from

2012 Journal Of Sexual Medicine

138. Acute management of priapism in men. (PubMed)

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

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2012 BJU international

139. Priapism is Associated with Sleep Hypoxemia in Sickle Cell Disease. (PubMed)

Priapism is Associated with Sleep Hypoxemia in Sickle Cell Disease. We assessed penile rigidity during sleep and the relationship of sleep abnormalities with priapism in adults with sickle cell disease.This was a case-control study of 18 patients with sickle cell disease and a history of priapism during the previous year, and 16 controls with sickle cell disease. Participants underwent overnight polysomnography and RigiScan® Plus recording to detect penile rigidity oscillations.The priapism (...) % but without CO(2) retention. Penile rigidity events were observed during rapid eye movement sleep and during stage 2 of nonrapid eye movement sleep, particularly in cases. The duration of penile rigidity events concomitant to respiratory events was higher in cases than in controls. Regression analysis revealed that the periodic limb movement and desaturation indexes were associated with priapism after adjusting for rapid eye movement sleep and lung involvement. Finally, oxyhemoglobin saturation less than

2012 Journal of Urology

140. Molecular Analysis of Erection Regulatory Factors in Sickle Cell Disease-Associated Priapism in Human Penis. (PubMed)

Molecular Analysis of Erection Regulatory Factors in Sickle Cell Disease-Associated Priapism in Human Penis. Priapism is a vasculopathy that occurs in approximately 40% of patients with sickle cell disease. Mouse models suggest that dysregulated nitric oxide synthase and RhoA/ROCK signaling as well as increased oxidative stress may contribute to the mechanisms of sickle cell disease associated priapism. We examined changes in the protein expression of nitric oxide synthase and ROCK signaling (...) pathways, and a source of oxidative stress, NADPH oxidase, in penile erectile tissue from patients with a priapism history etiologically related and unrelated to sickle cell disease.Human penile erectile tissue was obtained from 5 patients with sickle cell disease associated priapism and from 6 with priapism of other etiologies during nonemergent penile prosthesis surgery for erectile dysfunction or priapism management and urethroplasty. Tissue was also obtained from 5 control patients without

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2012 Journal of Urology

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