Conversion of Low‐Flow to High‐Flow Priapism: A Case Report and Review (CME)

Lutz, Austin; Lacour, S.

doi:10.1111/j.1743-6109.2012.02692.x

Cited by 18 publications

(17 citation statements)

References 11 publications

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“…19,20 This case shows us the importance of re-evaluation in treatment-resistant priapism. Especially in pediatric patients, detailed questioning may reveal the underlying cause, such as ingestion of pills.…”

Section: Discussionmentioning

confidence: 89%

Resistant pediatric priapism: A real challenge for the urologist

Sekerci

Akbal

Şener

et al. 2015

CUAJ

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Priapism in pediatric patients is a rare entity. We present an 8-yearold boy with known cerebral palsy. He came to the emergency department with sustained painful erection for 12 hours. Physical examination showed rigid penis. Blood count and biochemical analysis were normal. Although penile Doppler ultrasound revealed normal arterial and venous flow, cavernosal blood gas was hypoxic. A total of 50 mL of dark blood was aspirated, and 2 mL of 0.001% adrenalin solution was applied to both corpus cavernosum, twice within 20 minutes, which eventually did not achieve detumescence. A distal Winter shunt was performed at the end of which the penis was semi-flaccid. By the 18th hour of surgery, the penis re-gained painful erection status, so an Al-Ghorab shunt was performed. After the Al-Ghorab shunt, the penis was still in the semi-flaccid state. The next day, an angiography was performed and an arteriovenous fistula was discovered and treated by embolization. The flaccid state was achieved and the patient was discharged the day after the embolization.

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Section: Discussionmentioning

confidence: 89%

Resistant pediatric priapism: A real challenge for the urologist

Sekerci

Akbal

Şener

et al. 2015

CUAJ

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“…While the exact pathophysiologic mechanism is poorly understood, potential etiology includes essentially the creation of an iatrogenic arteriolar-sinusoidal fistula with shearing of the cavernosal arteries upon completion of distal shunting procedures [1,4,5]. A second mechanism may be due to disruption of the inherent vasorelaxing factors of the cavernosal system from ischemic insult during the IP episode [1,7,8].…”

Section: Discussionmentioning

confidence: 99%

“…NP can be confirmed with Doppler ultrasound, which shows high arterial flow in the cavernosal arteries leading to the erect state of the penis. Although rare, etiology may be secondary to previous trauma or arteriovenous fistula, and unremitting high-flow priapism may necessitate arterial embolization [1,4,5]. …”

Section: Discussionmentioning

confidence: 99%

Case Report: Conversion of a Low-Flow to High-Flow Priapism

et al. 2015

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Priapism is defined as an erection lasting for more than 4 hours and can be grouped into 3 distinct subtypes: ischemic (low-flow), stuttering and non-ischemic (high-flow). Herein, we present an interesting case of conversion from a low-flow to high-flow priapism after a distal shunting procedure. This is a rare phenomenon that has a paucity of documented cases. Diagnosis requires prompt clinical suspicion and confirmatory testing including penile cavernosal blood gases and Doppler ultrasound.

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“…Der Priapismus tritt erst dann auf, wenn entweder der Spasmus nachlässt oder das ischämische Segment abgebaut wurde. » Der High-flow-Priapismus tritt erst mit einer Verzögerung von 2-3 Wochen nach dem Trauma auf Seltene Ursachen eines nicht ischämi-schen High-flow-Priapismus sind maligne Erkrankungen des Penis [12], eine akute Rückenmarkverletzung [13] oder intrakavernöse Injektionen [14]. Spontan tritt diese Priapismusform kaum auf.…”

Section: Nicht Ischämischer Oder High-flow-priapismusunclassified

Diagnostik und Therapie des Priapismus

Kaminsky

Sperling

2015

Urologe

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Priapism is defined as an erection for more than 4 h without sexual stimulation. The most common form with nearly 95% is the ischemic or low-flow form, which is very painful. The other 5% are comprised of nonischemic high-flow type usually caused by a blunt perineal trauma and the recurrent or intermittent so-called stuttering priapism. Anamnesis as well as physical and laboratory examination are important during the diagnostic workup. Patients who suffer from sickle cell anemia are predestined to develop priapism. Priapism constitutes a urological emergency because especially the low-flow type has to be treated immediately to prevent a long-lasting fibrosis of the corpus cavernosa and a consecutive erectile dysfunction. The first step is the puncture and aspiration of blood from the corpus cavernosa if necessary combined with the injection of α-agonists. In case detumescence is not achieved, an operative shunt should be placed after an MRI. If there is a complete fibrosis of the corpus cavernosa possibly combined with penis deviation the implantation of a penile prosthesis is an option. The therapy of high-flow priapism is not as urgent as that of low-flow priapism because there is no risk of ischemia. If conservative therapeutic options fail, the superselective embolization of the fistula is the treatment of choice. In recurrent or intermittent priapism, the goal is to avoid new episodes with drug treatment. Because of the low incidence of priapism, it is very difficult to recommend and favor one therapeutic procedure.

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Conversion of Low‐Flow to High‐Flow Priapism: A Case Report and Review (CME)

Cited by 18 publications

References 11 publications

Resistant pediatric priapism: A real challenge for the urologist

Resistant pediatric priapism: A real challenge for the urologist

Case Report: Conversion of a Low-Flow to High-Flow Priapism

Diagnostik und Therapie des Priapismus

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