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At least 199 records · Page 11Linked to original sources
PubMed2003

[Spontaneous high flow arterial priapism of old males(one case report and review)].

OBJECTIVES: To investigate the correlation between corpus cavernosum disruption and high-flow priapism for the understanding of high-flow priapism and its treatment. METHODS: To report the clinical data of a case of spontaneous idiopathic high-flow priapism. RESULTS: The diagnosis was made as right cavernosal artery disruption after angiography. The result of cavernosal blood gas analysis was normal. The penis became detumescent after the gelatin embolization treatment was performed. CONCLUSIONS: Spontaneous high-flow priapism of old people(non-ischemic) is rare in clinic. Blood gas analysis and angiography are needed to find the hemorrhage site when conservative treatment fails. Gelatin embolization or cavernosal artery ligation are usually effective in the subsequent treatment.

Angiography↗
PubMed1992

[Priapism induced by intracavernous injection].

We report 16 cases of priapism in 13 of 404 patients who received intracavernous injection of vasoactive drugs to induce erection. In 10 patients the complication presented following injection of papaverine and phentolamine in combination. Despite reducing the dose of both agents, one patient had another episode of priapism. One patient who had been receiving papaverine alone in increasing doses with no results, developed priapism after the first injection of the combined treatment modality and again after the dose of both drugs had been reduced. Three cases presented priapism after injection with papaverine alone. One presented the complication again after injection of a reduced dose. The patients were seen after a sustained erection of 20 hours maximum on 15 occasions and one patient was seen after a sustained erection of 36 hours.

Adult↗
PubMedDate not supplied

Spontaneous resolution of delayed onset, posttraumatic high-flow priapism.

Priapism is an uncommon but serious condition with major long-term sequelae. The commoner, ischemic variety is a medical emergency requiring immediate intervention in order to avoid erectile dysfunction. However,the high flow variety is non-ischemic and the patient may not seek immediate therapy. The options of management for this rare, painless form of priapism vary from conservative therapy to embolization of the internal pudendal artery or, in some cases, surgery that may result in subsequent erectile dysfunction. We present a case of a 24-year-old man who presented with priapism of six-day duration, 10 days after perineal injury. Doppler ultrasonogram of the penis revealed a cavernosal artery pseudoaneurysm. Pudendal artery angiogram done four days later revealed no leak and the priapism subsided spontaneously with subsequent return of normal erections.

Adult↗
PubMedDate not supplied

[Value of cavernous gasometry in the physiopathologic diagnosis and treatment of priapism].

Currently, each case of priapism therapy must be customized depending on the patient's individual pathophysiology. To this end, in addition to anamnesis and the macroscopic aspect of the suctioned blood, quantification of existing ischaemia by cavernous gasometry is quite important. This will make possible the distinction between two types of priapism: ischaemic, vein-occlusive or low-flow; and nonischaemic, arterial or high-flow. Each of these priapism types presents a clearly different mechanism of production and, more importantly, a different response to the various therapeutic options currently available. The ischaemic form responds to suction-washing procedures and to the various techniques of vein by-pass. On the contrary, these manoeuvres will be useless in non-ischaemic or arterial priapism, where alpha-adrenergic injections or lacerated artery embolization should to be used.

Adult↗
PubMed1988

[Priapism induced by heparin. A more serious prognosis?].

Between 1973 and 1985, 31 patients were treated in the Urology Department of La Pitié hospital for priapism. Analysis of the aetiologies, determined in 25 cases, revealed a particularly high incidence of heparin as an aetiological factor for priapism. Surgical treatment was proposed in 28 patients. Independently of the type of surgical treatment performed and with a comparative preoperative delay, priapism as a complication of heparin therapy appears to be functionally more severe than priapism due to other aetiologies. Although the frequency, mechanism and prognosis of this complication of heparin therapy remain poorly understood, analysis of the 10 cases in this series and a review of the literature nevertheless provide certain answers.

Adult↗
PubMed1984

Priapism due to solid malignancy.

Although priapism secondary to hematologic malignancies has been well described, review of the literature reveals 75 case reports of priapism due to local corporeal involvement by solid tumors. Our recent experience with 6 cases of local invasion of the corporeal bodies is reviewed. Three transitional cell carcinomas, one prostatic adenocarcinoma, one rectal carcinoma, and one sarcoma comprise the series. Three patients presented with priapism as their chief complaint, and 3 patients presented with priapism as their first sign of recurrence. Therapy included corporeal curettage, surgery, radiotherapy, or chemotherapy. None of the modalities was entirely effective, although chemotherapy seemed to offer the best palliation.

Aged↗
PubMed1980

[Sickle cell priapism. Therapeutic considerations in the light of 23 cases (author's transl)].

In Zaire, homozygote sickle cell disease affects 2% of the population and the heterozygote form 1 subject in 10. In that country, this disorder is the most common cause of priapism. The authors report 23 cases of sickle cell priapism seen over a period of 15 years : 14 cases of homozygote sickel disease and 9 cases of heterozygote sickle disease. Since 1972, all cases of priapism in homozygote sickle disease have been treated with transfusions of concentrated erythrocytes and of hyperosmolar sodium lactate (M6). In heterozygotes, the preferred treatment remains spheno-cavernous anastomosis, which does not cause impotence. In 12 homozygote cases treated by transfusion and alkalinisation, there was only one failure and 11 successes despite the long period between the onset of priapism and the start of treatment (69 hours on average). Despite the long duration of these cases of priaspism, almost all the patients retained an intact virility.

Adolescent↗
PubMed1995

[High-flow priapism].

OBJECTIVES: A case of traumatic high flow priapism that had been successfully treated by selective embolization of the internal pudendal artery is described. METHODS: High flow priapism was diagnosed in a patient who presented with painless prolonged erection. He had fallen down from a horse twelve days before. The intracavernous blood gas analysis had arterial characteristics and erection did not subside with conservative management. Selective embolization of the internal pudendal artery was performed after visualization of an arteriocavernous fistula. RESULTS: Priapism disappeared just after the procedure and sexual potency was preserved. CONCLUSIONS: Selective embolization of the internal pudendal artery is an appropriate treatment for traumatic high flow priapism.

Adult↗
PubMed1995

High flow priapism associated with sickle cell disease.

Priapism associated with sickle cell disease is classically described as a low flow state. We report 2 cases of high flow priapism associated with sickle cell disease. High flow priapism has previously been reported almost exclusively in patients with traumatic rupture of the cavernous artery. Neither of our patients had historical or radiographic findings consistent with injury to the penile vasculature. One patient was treated unsuccessfully with intracorporeal injection of methylene blue and 1 underwent successfully bilateral pudendal artery embolization. The pathophysiological mechanism(s) responsible for the production of high flow priapism in patients with sickle cell disease is not known.

Adolescent↗
PubMed1995

[Priapism in the adult: report of 15 cases].

OBJECTIVES: The practical approach to the treatment of priapism is complicated by the rarity of this disease. Treatments for impotence by intracavernous injection of vasodilators have considerably increased the incidence of prolonged erections, although "antidote" protocols, when instituted rapidly, ensure detumescence in most cases. The objective of this study was to define a practical and rigorous approach based on comparison of our results with those reported in the literature concerning the management of priapism. METHODS: This series consists of fifteen consecutive cases observed in adults over a ten-year period. The pathophysiology and aetiologies are recalled. The authors evaluate the percentage of detumescence after primary treatment and after retreatment and discuss the incidence of secondary impotence. This information is compared with the data of the literature in order to define a practical approach. RESULTS: After a trial intracavernous injection of vasoconstrictors, creation of a cavernospongiosa fistula provided the best results with a 60% detumescence rate after primary treatment and 80% after retreatment. All treatments combined, 53.3% of good results were obtained after primary treatment and 66.7% after retreatment. In the long-term, 50% of patients with a sufficient follow-up are impotent. CONCLUSIONS: As a result of systematic surveillance of patients treated by an intracavernous injection protocol, the number of priapisms induced in our institution has remained stable over recent years. Patients treated for priapism within 36 hours have a better short-term and long-term prognosis.

Adult↗
PubMed1996

[Priapism induced by vasoactive drugs].

OBJECTIVES: Priapism induced by intracavernous injection of vasoactive drugs is uncommon, easily managed and carries a very low risk of possible sequelae. The pathophysiology, diagnosis and treatment of postinjection priapism is discussed. METHODS/RESULTS: The series of Schramer, Padma-Nathan, Levine and other authors are reviewed. The incidence of postinjection priapism has been found to be less than 0.5% in general, although the incidence has been reported to range from 3 to 12% when papaverine is used alone. CONCLUSIONS: Priapism induced by intracavernous injection of vasoactive drugs is uncommon and easily managed. Treatment, however, should be instituted rapidly.

Humans↗
PubMed1977

[Priapism--clinical aspects and treatment].

After references to definition, anatomic and physiologic foundations the author deals with the pathology of priapism. A clinical systematization of the diseases occurring together with priapism according to causal points of view is no more worth being advocated. It is completely unclarified to which extent the disease actually participates in priapism. After the description of the possibilities of a conservative medical treatment to the heparin and fibrinolysis therapy it is referred to the importance of the continuous drainage of the corpora cavernosa after Grayhack and Quackels. It is reported on two patients operated according to Grayhack. Results of surgical therapy reported in publications of the last time refer to an essential improvement of the prognosis of priapism.

Adult↗
PubMed1976

Factors predisposing to priapism in haemodialysis patients.

Clinical data and therapy of all male home dialysis patients of two centres were compared in order to establish predisposing factors to priapism. One centre (Frankfurt) had nine priapisms in 96 patients, whereas the other centre (Montpellier) had none in 59 patients. The only difference found were higher haematocrits in Frankfurt than in Montpellier. The highest haematocrits were found in the priapism patients. Further evaluation of the Frankfurt data showed that androgen therapy, high haematocrits and hypovolemia increase the risk of dialysis priapism. It is recommended to withdraw androgen therapy when the haematocrit is consistantly above 25%.

Adult↗
PubMed1998

Priapism: an unusual presentation of appendicitis.

Priapism, a persistent abnormal penile erection that is painful and unassociated with sexual interest, is known to be associated with a wide range of etiologies in children. This is a report of a case of appendicitis in an eight year old presenting with priapism. There is no mention in the pediatric literature of priapism associated with appendicitis. Possible appendicitis should be included in the differential diagnosis of priapism.

Acute Disease↗
PubMed1998

[Priapism. Our experience].

OBJECTIVE: We report our experience in the diagnosis, medical management and surgical treatment of priapism. METHODS/RESULTS: The clinical records of 67 patients that had been treated for priapism at our hospital from 1978-1994 were analyzed for age, race, occupation, marital status, symptoms, treatment, complications and time to remission of symptoms following treatment. Sixty-four patients were treated surgically and 3 patients were successfully treated medically. We performed 52 cavernospongiosal shunts, 14 sapheno-cavernous shunts and in 10 patients corpora cavernosa puncture was performed. The complications were sepsis, thrombosis, hematoma, phlebitis and urethral fistula. The complication rate was low for the cavernospongiosal shunt and corpora cavernosa puncture with phenylephrine. CONCLUSIONS: The highest incidence was observed in patients aged 15-40 years, with a prevalence in the black race. The principal presenting feature was a painful erection without sexual contact. Idiopathic priapism was the most prevalent, although the sickle cell anemia was an important etiological factor. The surgical technique most commonly used was the cavernospongiosal shunt. Intracavernosal injection of phenylephrine was the treatment of choice for pharmacological priapism. Seven patients had erectile dysfunction.

Adolescent↗
PubMed1998

[Management of priapism induced by PGE1].

OBJECTIVE: To review the literature on priapism following intracavernous injection of PGE1, its management and the physiopathological mechanisms involved. METHODS/RESULTS: The literature on PGE1-induced priapism available on Medline is reviewed and two cases treated at our hospital are described. The diagnostic and therapeutic algorithms are presented. The relationship between drug use and priapism is difficult to establish since patients with the same history who received the same dose of Alprostatil did not develop priapism. CONCLUSIONS: Although infrequent, treatment must be instituted urgently since there is generally low flow.

Alprostadil↗
PubMed2002

Clitoral priapism: a rare condition presenting as a cause of vulvar pain.

BACKGROUND: Priapism of the clitoris is a rare condition associated with prolonged erection of the clitoris causing engorgement, swelling, and pain to the clitoris and immediate adjacent area. CASE: A 47-year-old woman presented complaining of vulvar and clitoral pain. Self-reported findings of a swollen and tender clitoris had been confirmed by physical examination during an episode of priapism, otherwise there were no abnormal findings on routine evaluation. The history and findings of prolonged clitoral swelling, tenderness, and pain of the clitoris and adjacent area were considered consistent with clitoral priapism, and discovered to be attributed to the use of trazodone hydrochloride, a heterocyclic antidepressant. The patient was initially treated with imipramine hydrochloride; however, it was the withdrawal of the medication instigating the condition that was the focal point in its management. CONCLUSION: Priapism of the clitoris is a condition that may develop during therapy with certain medications, specifically those possessing a strong alpha-adrenergic blockade. Conditions altering blood flow to the clitoris may also predispose to developing this condition. Familiarity with this condition and a high index of suspicion are paramount in establishing a diagnosis.

Antidepressive Agents, Tricyclic↗
PubMed1999

Nefazodone-induced clitoral priapism.

A case is presented of painful priapism of the clitoris lasting 3 days, with a strong temporal association with the administration of nefazodone hydrochloride. Priapism has been described as a rare side-effect of drugs with high alpha1-adrenergic blocking potential. However, the alpha1-adrenergic blocking potential of nefazodone is moderate. Drug-induced clitoral priapism has been described for citalopram, bromocriptine, fluoxetine and trazodone combined with fluoxetine. To our knowledge, this is the first report in the literature about priapism of the clitoris associated with nefazodone.

Antidepressive Agents, Second-Generation↗