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PubMed1980

Provoked priapism in sickle cell anemia.

Two patients with sickle cell anemia are reported who developed relative impotence after repeated episodes of priapism. They learned that excessive ethanol ingestion produced an erection and utilized this mechanism to satisfy sexual partners. Hospitalization and transfusion therapy were required for repeated episodes of priapism. Extensive interviews were required in order to learn the sequence of events. This synergistic relationship between ethanol and priapism should be sought in patients with repeated hospitalizations for this complication of sickle cell anemia because it is preventable with appropriate counseling.

Adult↗
PubMed1994

Intermittent priapism associated with lumbar spinal stenosis.

Nine patients with intermittent priapism associated with lumbar spinal stenosis are described. They had severe intermittent claudication and priapism when walking, and 7 had sensory disturbances affecting the lumbosacral nerve roots at rest. Radiographs showed degenerative central stenosis in 6, and degenerative spondylolisthesis in 3. Seven were treated by surgical decompression and 2 refused operation. Six of the 7 had improvement in their priapism, but symptoms recurred in one as a result of spondylolisthesis developing after operation.

Aged↗
PubMed1997

Effect of pentoxifylline on veno-occlusive priapism-induced corporeal tissue lipid peroxidation in a rat model.

OBJECTIVE: To investigate whether pentoxifylline could play a role in attenuation of the hazardous effects of ischemia/reperfusion on corporeal tissue in a rat model of veno-occlusive priapism (VOP). MATERIALS AND METHODS: Placebo and pentoxifylline were given to eight groups of rats prior to priapism being induced by a vacuum constrictive device for durations of 6 and 12 h, respectively. Half of the groups of rats that underwent the same duration of priapism (ischemic) were subjected to 1 h of detumescence after band removal (reperfusion). One group underwent no manipulation and no drug administration and served as a baseline determination (control). Corporeal homogenates were examined for lipid peroxidation (LP) derived malondialdehyde (MDA) accumulation via thiobarbituric acid assay. RESULTS: MDA concentration differed significantly between VOP rats and controls (P < 0.001) but did not differ significantly between ischemic-only groups and reperfused groups (P < 0.05). In the pentoxifylline-pretreated groups, although MDA accumulation tended to be slightly lower than in the placebo groups, the difference was not statistically significant (P < 0.05) either in the 6- or 12-h duration priapic groups. CONCLUSIONS: LP, an indicator of radical oxygen metabolite (ROM) induced injury, occurs in rat corporeal tissue during and after abolishment of VOP. Single-dose pentoxifylline pretreatment failed to exert a protective effect on corporeal tissue in a rat model of VOP in terms of attenuation of LP.

Animals↗
PubMed1989

99mTc penile scan: an investigative modality in priapism.

A 99mTc penile scan was performed in 9 patients with priapism. The technique of the procedure is described. Penile scan is an easily obtainable modality that can differentiate between high- and low-flow forms of priapism. We believe that these scintigraphic findings facilitate management of priapism.

Adolescent↗
PubMed1983

A new concept of priapism based on the results of arteriography and cavernosography.

Four patients with priapism - 3 with idiopathic and 1 with post-traumatic etiologies - were examined by arteriography and cavernosography. The findings of these examinations as well as distinct clinical findings suggest that there are 2 different types of priapism. One is characterized by severe blood stasis within the corpora cavernosa with resulting compression of the deep arteries of the penis and reduction of arterial blood flow. In the other type, arterial flow into the corpora cavernosa and drainage into the veins are substantially increased. In this type, long-standing priapism does not seem to produce fibrosis of the corpora cavernosa with resulting impotence.

Adult↗
PubMed2004

High-flow priapism in acute lymphatic leukaemia.

Priapism is defined as prolonged and persistent erection of the penis without sexual stimulation. It is associated with excessive hyperleukocytosis (e.g. in acute or chronic leukaemia); however, this complication is rarely seen in the pediatric population. We report a 12-year-old boy suffering from acute leukaemia presenting with, at first intermittent, but increasingly persistent erection. Doppler US revealed signs of high-flow priapism. MRI excluded intrapelvic tumour masses, and three-dimensional contrast-enhanced MR angiography could not demonstrate an arteriovenous fistula or thrombosis. Cavernosal blood-gas measurement was in agreement with high-flow priapism. On the basis of the imaging findings, invasive therapeutic management was avoided in our patient with a successful outcome.

Child↗
PubMed2002

MRI and color-coded duplex sonography: diagnosis of partial priapism.

A case of partial priapism is reported diagnosed by contrast-enhanced MR imaging and color-coded duplex sonography. Follow-up examinations after 4 weeks and 3 months were performed. According to the results of color-coded duplex sonography and MRI, a partial priapism with development from the subacute stage to a fibrous residuum after spontaneous lysis was diagnosed. There are only very few cases of partial priapism reported in the literature and this is the first case report that demonstrates diagnosis and follow-up both by color-coded duplex sonography and contrast-enhanced MR imaging.

Diagnosis, Differential↗
PubMed2004

High-flow priapism: colour-Doppler ultrasound-guided supraselective embolization therapy.

High flow priapism is mainly caused by traumatic arteriocavernous fistulas. The standard therapy is a transcatheter embolization of the fistula. This study analyzes the combined approach of arteriography and color Doppler ultrasound during the embolization procedure. During the arteriography procedure, a perineal color Doppler ultrasound examination of the fistula was performed to achieve an optimal positioning of the catheter tip in the fistula with a minimum of radiation exposure. To visualize the correct localization, ultrasound contrast medium or saline solution was injected through the catheter. The flow-pattern of the contrast medium allowed evaluation of the successful occlusion of the fistula and preservation of the unaffected penile arteries. In six patients (unilateral fistula: three, bilateral fistulas: three) with a posttraumatic high-flow priapism, this technique was performed for embolization of the fistulas. A total of nine embolization sessions were performed. Only one case required a second session due to dislocation of a microcoil. In all cases, the priapism disappeared immediately after the final session while erectile function was restored within 4 weeks after embolization. The combined approach of x-ray and ultrasound imaging facilitates the supraselective embolization of the arteriocavernous fistula, leading to an optimal success rate, while reducing the radiation exposure and the applied dose of contrast medium.

Embolization, Therapeutic↗
PubMed2002

The etiology, diagnosis, and treatment of priapism: review of the American Foundation for Urologic Disease Consensus Panel Report.

Priapism is an important medical condition that requires immediate evaluation, and depending on etiology, may require emergency management. Based on the classification scheme offered by a recent consensus panel, priapism can be subdivided into ischemic and nonischemic types. The nonischemic type, usually the result of perineal trauma, can be treated with conservative therapy, whereas the nonischemic type, which arises from many varied causes, mandates immediate intervention. Corporal fibrosis and permanent erectile dysfunction can result from ischemic priapism that fails to resolve with therapy.

Consensus Statements as Topic↗
PubMed1978

Priapism and multiple myeloma. Successful treatment with plasmapheresis.

Priapism was associated with multiple myeloma and hyperviscosity in a sixty-year-old black male. Plasmapheresis treatment of the hyperviscosity corrected his priapism, and chemotherapy for the underlying multiple myeloma prevented the recurrence of priapism after a chronic intermittent history of seventeen years.

Humans↗
PubMed1992

Priapism associated with asplenic state.

Priapism may be primary (idiopathic) or secondary to sickle cell anemia, trauma, leukemia, drugs, venous thromboembolic diseases, and other less common disorders. This study concerns 21 patients with priapism treated during a period of ten years. Nine patients (43%) had sickle cell anemia. Of the 12 individuals (57%) classified as idiopathic, 3 (25%) had previously undergone surgical splenectomy for benign conditions. Considering the propensity for this unusual condition to develop in patients with hemoglobinopathy-induced hyposplenism, the possibility of a relationship between the asplenic state and priapism is considered.

Adult↗
PubMed1994

Corporeal fibrosis as a result of priapism prohibiting function of self-contained inflatable penile prosthesis.

Corporeal fibrosis and erectile impotence are known sequelae of priapism. Fibrosis following priapism may make subsequent placement of a penile prosthesis, especially inflatable devices, difficult or impossible. A case is described in which a self-contained inflatable prosthesis (Dynaflex) was successfully placed to treat impotence resulting from idiopathic priapism. However, fibrosis of the distal tunica albuginea of the corpora cavernosa rendered them noncompressible, and thus precluded inflation of the device with its distally placed pump mechanism. This anatomic problem is added to the list of potential contraindications to placement of self-contained inflatable penile prostheses, and the advisability of having patients who desire such a prosthesis also choose a secondary prosthesis type is emphasized.

Adult↗
PubMed2005

Ziprasidone-induced priapism requiring surgical treatment.

Both typical and atypical antipsychotic psychotropics have been reported to cause ischemic priapism presumptively secondary to alpha1-adrenergic blockade. This condition is a urologic emergency for if not evaluated and treated appropriately, long-term sequelae include erectile dysfunction and impotence. This paper addresses the first reported case of priapism requiring surgical intervention presumed to be secondary to ziprasidone. Increased clinician and patient education regarding priapism is required in order to minimize this adverse event and to maximize immediate treatment.

Adult↗
PubMed2004

Stuttering priapism associated with withdrawal from sustained-release methylphenidate.

Stuttering priapism is intermittent, prolonged, painful, pathologic erections with intervening periods of detumescence. An adolescent had stuttering priapism associated with withdrawal from sustained-release methylphenidate. To our knowledge, this is the first such report of stuttering priapism associated with stimulant drugs for treatment of attention deficit hyperactivity disorder.

Adolescent↗
PubMed2005

Intracavernosal etilefrine self-injection therapy for recurrent priapism: one decade of follow-up.

Recurrent idiopathic priapism is a rare condition that, if not properly treated, may lead to impaired quality of life and erectile dysfunction. Treatment can be achieved by prevention of priapism episodes with systemic therapy or by early intervention with intracavernosal self-injection of sympathomimetic agents. We describe a case of a young patient with recurrent idiopathic priapism who has used etilefrine self-injection for the past 10 years with good efficacy and libido and erectile function preservation. This report suggests that this approach may be safely indicated in selected cases, particularly when sexual function preservation is a major concern.

Adult↗
PubMed2005

Tadalafil-associated priapism.

A healthy 46-year-old man presented to the Emergency Department with a 36-hour history of persistent, painful erection after taking the cyclic guanylyl monophosphate-specific phosphodiesterase 5 inhibitor tadalafil. He had no other identified contributing factors for priapism. After confirmation of ischemic priapism and failure of bedside management in the Emergency Department, the patient underwent operative caverno-spongiosal shunting. Postoperatively, the erection initially rebounded but gradually receded with manual compression over 48 hours. At outpatient follow-up, the patient remained flaccid without erections. To our knowledge, this is the first report of tadalafil-associated priapism.

Adult↗
PubMed2005

Priapism associated with routine use of quetiapine: case report and review of the literature.

We report a case of priapism occurring in a patient taking a standard daily dose of the atypical antipsychotic quetiapine (Seroquel). To our knowledge, this represents the second published report associating quetiapine with priapism, and the first to associate priapism with routine dosing of the drug. Previously published studies have suggested that alpha-adrenergic blockade may be the mechanism of action for this side effect. We report successful management in this case with cavernosal aspiration followed by intracavernosal injection of phenylephrine.

Antipsychotic Agents↗
PubMed2006

Testosterone-induced priapism in Klinefelter syndrome.

We present the case of a patient with Klinefelter syndrome and priapism after testosterone administration. The patient underwent testicular sperm extraction for interventional fertilization, but no sperm were found. Because he had given up trying to father a child and his testosterone level had been low, testosterone replacement therapy was started with testosterone enanthate. After the third injection, he presented with low-flow priapism. Conservative management was successful, and no recurrence developed during the next 15 months. Testosterone replacement therapy carries some risk of priapism even for patients with Klinefelter syndrome.

Adult↗