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A 4-year-old, male Newfoundland cross was presented for lethargy, anorexia, and dysuria. The main clinical finding was an enlarged and painful prostate gland. While the dog was hospitalized, priapism developed. Following euthanasia, microscopic examination revealed that a carcinoma involving both bladder and prostate gland had widely metastasized to the penile vasculature.
The surgical outcome in 66 patients with priapism who presented at the University College Hospital, Ibadan, over a ten-year period was evaluated. Operative procedures carried out included bilateral cavernostomies in 23 patients, caverno-glandular shunts in 11, caverno spongiosal shunt in 18 and caverno-saphenous shunt in 1. Complete detumescence was achieved immediately postoperatively in all patients, however, this was not maintained. Some turgidity recurred after twenty-four hours in all patients. In 12 patients with recurrence of turgidity, 8 had flaccid penis after. Long-term results and follow up in these patients are scanty due to default, but of the 12 that were followed up for a period ranging from 2 months to 2 years, 6 are still able to achieve and maintain an erection, while 6 had no erection at all. Two of five patients who had conservative treatment are able to achieve and maintain an erection. The outcome of surgical treatment appears to be superior to conservative treatment. Bilaterial cavernostomies appear to be effective, but when this fails a shunt procedure should be carried out.
Four cases with high flow priapism are described herein. Patient evaluation included intracavernal blood-gasmetry, echo Doppler, selective arteriography of the pudendal artery. Three patients had a previous history of trauma and one patient was on psychotropics. The alpha-agonist drugs and the different shunt techniques did not achieve detumescence. Two embolization procedures of the internal pudendal artery were performed with good long-term results. The other two cases achieved spontaneous detumescence. No complications or secondary erectile dysfunction were observed.
As a result from the mechanical irritation provoked on the sacral roots, the cauda equina compression syndrome can involve, as part of its symptomatic state, involuntary erections and mictional disorders which arise when standing and stretching the spine. In the eight cases of priapism from this cause reported in the international literature, surgical decompression has solved the clinical picture. We now present a new case with the peculiarity that, following unsuccessful surgical therapy, the infiltration of the compromised spinal roots has rendered excellent results.
We report a case of traumatic priapism with an evolution of three weeks at the time of the diagnosis. The foregoing condition had been caused by an arteriocavernal fistula. Several arteriograms and selective embolization of the compromised area were required for treatment. The etiological, pathophysiological and therapeutic aspects are discussed.
Behçet's disease (BD) is a multi-system inflammatory disorder which may involve the vascular system. Currently, it is general practice to use the International Study Group (ISG) criteria for the diagnosis of BD. However, even though vascular involvement may be seen in one-fourth to one-half of BD patients, and occasionally is the presenting and only manifestation of BD, large vessel disease is not included among the ISG criteria. In this report we describe a patient who had deep venous thrombosis and priapism, but who does not fulfill ISG criteria for the diagnosis of BD.
The authors report a case of high-flow priapism in an adolescent due to rupture of the deep penile artery after falling astride, confirmed by Doppler ultrasound on the third day after the accident, and treated successfully by highly selective embolization with no harmful effects on erectile function.
OBJECTIVE: To evaluate the diagnosis and treatment of high-flow priapism (HFP). METHODS: Four cases of HFP following blunt trauma to the penis or perinea underwent diagnostic examination by colour-flow Doppler ultrasound and/or superselective pudendal arteriography, which revealed bilateral arteriocorporal fistula in 1 case and monolateral in the other 3. Penile detumescence was obtained in 2 cases by superselective bilateral/monolateral arteriographic embolization of the pudendal artery with absorbable gelatin RESULTS: The former 2 cases effected an immediate recovery of the sponge, while the other 2 cases received conservative treatment. Erectile function, able to perform normal sexual intercourse in approximately 2 months. But in the latter 2, follow-up revealed unsatisfactory potency. CONCLUSION: Superselective arteriographic embolization with absorbable gelatin sponge can provide a safe, selective and effective treatment for HFP patients.
A case of malignant priapism is described in a 58-year-old patient with metastatic carcinoma of the bladder. The diagnostic methods and the possibilities of palliative treatment are discussed.
A 42-year-old man with priapism is reported. The condition did not improve by cavernous body irrigation with heparin, intravenous administration of anticoagulant, or various surgical shunt operations. However, the condition improved after local radiation therapy: a total dose of 6Gy, 1.5 Gy daily for 4 days, was given to a site 24 cm x 24 cm which covered the small pelvic cavity and the femoral area centering around the root of the penis. Improvement of the condition became evident from Day 3 of radiation therapy. For about 1 year since then the patient has been entirely free of recurrence.
Twenty cases of Priapism were managed surgically over a 3-year period with the A1-Ghorab modification of the caverno-glandular shunt. The procedure was simple and short. Except for post-operative bleeding in 2 patients, no major complications were encountered. Post-operative potency rate of 39 per cent was achieved. Late presentation and repeated previous episodes may have contributed to this low potency rate.
We report a 14 year old boy who had priapism induced by vivax malaria. The onset was latent and course was protracted, refractory to anti-malarial and conservative treatment, but satisfactory detumescence was achieved after surgical intervention.
A case of intermittent priapism with neurogenic claudication caused by spinal stenosis is reported. The symptoms disappeared completely after decompressive laminectomy.
We present a rare case of priapism in a child, ten years old, in association with Fabry's disease. The child had a history of disseminated nodular enlargement, crises of fever, intermittent pain in the extremities and ten hours persistent painful erection of the penis. We don't obtain pain or erection relief with sedation, epidural block and irrigation of the corporal bodies. A saphenous-cavernous shunt, in the Grayhack fashion made, being results satisfactory. In the follow-up, the child had sporadic pain in the extremities and no erection of the penis. The cavernosography showed the shunt open. Fabry's disease was confirmed by nodular biopsy and the demonstration of deficient alpha-galactosidase.
A case of priapism complicating essential thrombocythaemia in a 45-year old Nigerian gardener is described. His platelet counts ranged from 1.2-1.6 x 10(12)/L, haematocrit from 0.25-0.33 L/L and leucocytes from 23.4-30.6 x 10(9)/L. There was a splenomegaly of 5cm. He had bilateral cavernostomy but is yet to regain penile erection 3(1)-2 months after surgery.
A case of priapism is described which complicated treatment of impotence with local injections of papaverine. A review is presented of the pertinent literature on the principles and complications of local pharmacotherapy of erection disturbances.
Prostatic carcinoma metastasising to the penis is a rare occurrence with only 56 cases reported in the literature. The incidence of transitional cell carcinoma arising primarily in the prostate ranges from 1. 5 to 4%. These tumors have uniformly poor prognosis regardless the type of therapy. Most of the patients die within two to six moths and very few survive beyond twelve months. A case of transitional cell carcinoma of the prostate with penile metastases and priapism is presented.
A 4-year-old castrated mixed-breed dog had atypical signs of chronic distemper encephalomyelitis. The predominant signs were related to visceral rather than somatic dysfunction. The visceral dysfunction was largely attributable to distemper-associated inflammatory lesions in the spinal cord and resulted in fecal incontinence, urinary incontinence, and priapism. Empirical treatment of the dog resulted in transitory improvement prior to euthanasia performed because of the progressive nature of the encephalomyelitis.