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At least 343 records · Page 19Linked to original sources
PubMed1992

The usefulness of ethylephrine (Efortil-R) in the treatment of priapism and intraoperative penile erections.

We present our experience in the treatment of 8 patients with priapism after intravenous injection of vasoactive drugs, and of 15 patients with persistent erections in the course of transurethral cystoscopy surgery. All of them were treated with intracavernous injection of 10 mg ethylephrine (1 ml Efortil-R). The results were satisfactory in all cases. In one patient we had to draw 75 ml blood and give another 10 mg dose of ethylephrine. We have not observed secondary effects of drug administration except two local haematomas with spontaneous resolution. We consider that this treatment is very useful in the management of patients with persistent erections or priapism because of the excellent results obtained without adverse effects.

Aged↗
PubMedDate not supplied

Selective arterial embolization of idiopathic priapism.

We report a case of idiopathic priapism that was only identified as high-flow or arterial priapism after drainage of the corpora cavernosa. Following failure of conservative and surgical treatment attempts, two consecutive embolizations of a unilateral penile artery were performed with gelgoam particles.

Adult↗
PubMed1983

Treatment of priapism by transcatheter embolization of internal pudendal arteries.

Priapism can be successfully treated by unilateral or bilateral percutaneous transcatheter occlusion of the internal pudendal arteries. Occlusion should be reversible in order to avoid impotence. Embolization with autologous clot satisfies this requirement because of the clot lysis and consequent vessel recanalization. Three cases are extensively described which demonstrate the feasibility of the method and the ability to preserve sexual potency. The rationale for using interventional angiography in priapism is also discussed.

Adult↗
PubMed1998

[High-flow priapism following blunt perineal trauma. Interventional therapy].

A 10-year old boy developed an arteriocavernosal fistula with a permanent penile erection (high-flow priapism) after a blunt perineal trauma. The diagnosis was established by Doppler ultrasound, blood gas analysis and angiography. A conservative treatment attempt with penile cooling and puncture of the cavernosal corpera with blood aspiration and etilefrine instillation failed to resolve the priapism. An embolization of both bulbocavernosal arteries was followed by an immediate detumescence. Normal functional erection was preserved. No recurrence was observed during a follow-up of 6 months.

Accidents, Traffic↗
PubMed1997

[Post-traumatic priapism in a 10-year-old boy].

The case of a 10-year-old boy with post-traumatic priapism after perineal trauma is presented. Interdisciplinary treatment using angiography and selective catheter embolization for juvenile high-flow priapism is demonstrated. The literature and the diagnostic possibilities resulting from color duplex sonography are discussed.

Arteriovenous Fistula↗
PubMed2000

Use of Doppler ultrasound and 3-dimensional contrast-enhanced MR angiography in the diagnosis and follow-up of post-traumatic high-flow priapism in a child.

We report a 7-year-old boy with post-traumatic arterial priapism. Doppler US could not reliably identify or exclude a fistula. MR angiography did not demonstrate an arteriovenous fistula and the child was treated conservatively. The ideal imaging modality should demonstrate the presence or absence of a clinically significant causative lesion which, in high-flow arterial priapism, may need intervention. Three-dimensional, contrast-enhanced MR angiography appears to fulfil these requirements. On the basis of the non-invasive imaging findings, invasive intervention was avoided in this case with a successful outcome.

Child↗
PubMed2004

Superselective embolization in posttraumatic priapism with glubran 2 acrylic glue.

Two patients with posttraumatic priapism underwent transcatheter embolization using microcoils, resulting in temporary penile detumescence and an apparent resolution of the artero-venous fistula. In both cases, priapism recurred 24 hours after the procedure and was successfully treated through selective transcatheter embolization of the nidus using acrylic glue (Glubran 2). The patients showed complete recovery of sexual activity within 30 days from the procedure and persistent exclusion of the artero-venous fistula after a 12-month follow-up.

Adhesives↗
PubMed2004

Thrombosis and priapism in a patient with Henoch-Schonlein purpura.

Henoch-Schönlein purpura (HSP) belongs to the category of systemic small-vessel vasculitis. Although long-term outcome is generally good, serious complications may occur. Thrombosis and priapism have been reported only as extremely rare complications of HSP. We describe a 37-year-old man who developed recurrent thrombotic events shortly after he had been diagnosed as having HSP. Although he had additional risk factors for thrombosis, such as prothrombin G20210A mutation and use of celecoxib before the last episode, temporal relation of the thrombotic attacks to the onset of HSP suggest that the disease itself may lead to a prothrombotic state. This case is the first adult HSP patient with priapism, which probably developed secondary to thrombosis of the dorsal penile vein.

Adult↗
PubMed2004

Paediatric priapism--treatment conundrum.

Priapism is a rare condition in childhood. The majority of reported cases are boys with sickle cell disease, in whom nonoperative management may be successful when patients present early. We report a 14-year-old boy with sickle cell disease who presented with priapism of 72-h duration and was successfully treated by bilateral saphenocorporal shunts.

Adolescent↗
PubMed1975

Priapism in boys. Management with cavernosaphenous shunt.

Two children with priapism are presented; one case was secondary to trauma and the other was idiopathic in nature. Both boys were effectively treated by bilateral corporosaphenous shunts. The mechanism of normal erection and the pathophysiology of priapism are discussed.

Adolescent↗
PubMed1980

Amyloidosis presenting as priapism.

A sixty-five-year-old white man presented with sudden onset of painful, priapism. Review of pathologic specimens at the time of surgical decompression revealed massive amyloid infiltration. Purpura, organ enlargement, gastrointestinal bleeding, and congestive heart failure developed subsequently. Postmortem examination revealed widespread amyloidosis. To our knowledge this is the first report of amyloidosis presenting with priapism.

Aged↗
PubMed2005

Juvenile posttraumatic high-flow priapism: current management dilemmas.

High-flow priapism results from disruption of the intercavernosal artery resulting in an arteriocavernosal fistula and is rarely encountered in the pediatric and adolescent population. Clinically it manifests as a painless, prolonged erection after perineal trauma. Treatment has ranged from expectant management to open surgical exploration with vessel ligation. Internal pudendal arteriogram and superselective embolization with autologous blood clot has emerged as a safe and effective treatment modality in the young male population. Here the authors present 3 patients with high-flow priapism and discuss management of this rare clinical entity.

Adolescent↗
PubMed2004

Idiopathic intracranial hypertension: priapism of the brain?

It has long been recognized that a clinical syndrome similar to idiopathic intracranial hypertension can occur secondary to venous sinus obstruction with the elevation in sinus pressure causing a reversal in the pressure gradient across the arachnoid granulations and therefore elevated CSF pressure. There remains, however, a group of predominantly obese female patients with elevated CSF pressures who have either no apparent abnormality of venous outflow or a tapering, apparently extrinsic compression, of their dominant transverse sinuses on catheter venography. This suggests that venous collapse may be associated in some way with the cause of the elevated pressure but clearly something else must be initiating the pressure rise or a circular argument ensues. Elevated CSF pressure compresses the veins, which then elevates CSF pressure. However, collapse of the venous sinuses secondary to the elevated CSF pressure once initiated may exacerbate the condition. It has been suggested that the initiating event leading to the elevated pressures in the idiopathic group of patients may be caused by cerebral hyperaemia and cerebral dysautoregulation. Priapism is a condition of pathological elevation of venous pressure of the male genitalia in which there are two forms: (1) venous out flow obstruction and (2) hyperaemia due to a to loss of regulation of blood flow and secondary venous out flow compression. Review of the literature suggests the pathophysiology of idiopathic intracranial hypertension may be analogous to that of priapism.

Brain↗
PubMed2006

Stuttering priapism after ingestion of alfuzosin.

A patient who presented with priapism after ingestion of alfuzosin is described. He presented with recurrent priapism, which was relieved temporarily after physical exercise. It did not subside with pharmacologic management and was managed surgically using Winter's procedure. It remained quiescent for a short period, only to reappear later. After additional conservative management, he was well enough to be discharged. At 12 months of follow-up, he was well, had no penile fibrosis, was able to have unaided intercourse, and had moderately bothersome lower urinary tract symptoms. This case illustrates that no therapeutic drug is without side effects and emphasizes the need to warn patients appropriately.

Adrenergic alpha-Antagonists↗
PubMed2001

[Surgical treatment of priapism with open glans penis puncture-drainage in 26 black patients].

The surgical treatment of the priapism is complex and requires various techniques for diversion of the corpora cavernosa with significant morbidity. For the last 15 years, the author have been using a simple transglandular cavernosal spongiosum shunt technique, which satisfies the requirements of functional surgery: restoration of anatomy, reduced morbidity, facility to learn. This article is intended to precisely describe the surgical technique and to present the results based on a personal series of 26 cases of priapism operated with this technique in black patients (19 adults and seven children) in the context of sickle-cell anaemia.

Adolescent↗
PubMed1994

Oral terbutaline for the treatment of priapism.

The widespread use of penile injections in the management of erectile dysfunction has led to an increased incidence of priapism. It has been suggested that terbutaline, a beta-agonist, might be beneficial in treating priapism in this setting. We randomized 24 patients with prolonged erections to a prospective, double-blind, placebo-controlled trial. We did not find any benefit of oral terbutaline over placebo in these patients.

Administration, Oral↗
PubMed1993

High flow priapism: a spectrum of disease.

We describe 4 cases of high flow arterial priapism, ranging from 1 week to 3 years in duration. The mode of presentation, evaluation using a duplex scanner, treatment and ultimate resolution are discussed. In 1 patient treated with ice compression the erection subsided spontaneously. One patient underwent percutaneous embolization and achieved detumescence. In 2 men a vascular pseudocapsule formed around the site of the ruptured cavernous artery that provided an important anatomical landmark for intraoperative localization. The ruptured branch of the cavernous artery was ligated in an open procedure. Based on these cases and a review of the literature, we outline a modified diagnostic and therapeutic approach for patients with high flow arterial priapism.

Adolescent↗
PubMed1993

Delayed high flow priapism: pathophysiology and management.

Two cases of the management and pathophysiology of high flow arterial priapism are presented. Both cases were post-traumatic with delayed onset of priapism and both had angiographically diagnosed arteriocorporeal fistulas. Case 1 was managed with selective cavernous artery ligation and case 2 resolved spontaneously, both with excellent return of premorbid levels of erectile function. We propose that the pathophysiological mechanism involves injury to the intracavernous artery, causing ischemic necrosis. After a delay the arterial segment blows out, leading to unregulated blood flow into the corpus cavernosum. Management with surgical ligation is highly selective and nondisruptive to unaffected vessels, offering precise control of the bleeding vessel.

Adult↗