Intrazerebrale Massenblutung nach intrakavernöser Metaraminol-Behandlung einer prolongierten Erektion

Rösener, MT; Wechsel, H. W.; Dichgans, J.

doi:10.1055/s-2008-1057836

Cited by 9 publications

(4 citation statements)

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“…To prevent the occurrence of complications, the medication must only be injected into a fully erect penis [ 15 ]. Local application of above-mentioned medications can lead to systemic complications – increase of blood pressure up to 200 mmHg and hemorrhagic stroke [ 16 , 17 ]. In patients with high risk of cardiovascular pathologies, electrocardiogram and blood pressure monitoring are strongly recommended during priapism medication.…”

Section: Discussionmentioning

confidence: 99%

SEXUAL DISORDERS Our experience in the treatment of priapism

Vorobets¹,

Banyra²,

Stroy³

et al. 2011

cejurol2/2011

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Priapism is a persistent erection without sexual stimulation that cannot be relieved by orgasm. Its etiology includes the impaired mechanism of detumescence caused by the abundant release of neurotransmitters, venules obstruction, impairment of the intrinsic mechanism of detumescence, or prolonged relaxation of the intracavernous smooth muscles. Treatment of priapism is conservative, pharmacological, or surgical. Efficient treatment options include the intracavernous vasoconstrictor injections or surgical shunting. Alternative treatment options include the intracavernous methylene blue injections or selective penile arterial embolization. Between 2001 and 2009, we treated 10 patients with priapism at our clinic. According to our data, priapism as a complication after intracavernous administration of prostaglandin E1 occurs in 2.7% of patients, after additional administration of prostaglandin E1 and phentolamine – in 5.0% patients, after administration of papaverine – in 8.3% patients. The obtained results allow recommendation of prostaglandin E1 as a medication of choice among the vasoactive substances for intracavernous use due to high efficacy and low side effects. Initially all cases of priapism must be treated pharmaceutically, but can be converted to surgery as needed. Unilateral transcaputal puncture of the cavernous body (shunting after Winter) in our patients with ischemic priapism allowed to achieve detumescence in 100% of cases without subsequent recurrence and to restore erectile function in 30% of patients.

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Section: Discussionmentioning

confidence: 99%

SEXUAL DISORDERS Our experience in the treatment of priapism

Vorobets¹,

Banyra²,

Stroy³

et al. 2011

cejurol2/2011

View full text Add to dashboard Cite

show abstract

“…In order to'avoid systemic complications, it is of outstanding importance to inject the agent into the fully erected corporeal cavernosa onb (Potempa et al, 1991). As no blood is retained in the penis, local administration of these agents may lead to systemic complications such as sustained hypertension up to 200 mmHg or cerebral bleeding (Bastuba et al, 1994;Rosener et al, 1995).…”

Section: Mechanical and Pharmacological Therapymentioning

confidence: 99%

New aspects in the treatment of priapism

Portillo

Jünemann

2009

Andrologia

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Summary. Recent advances in the understanding of erectile physiology have improved the prompt diagnosis and treatment of priapism. During initial assessment, the physician must distinguish between veno‐occlusive low flow (ischemic) and arterial high flow (nonischemic) in order to choose the correct treatment option for each type of priapism. Patient history, physical examinition, penile haemodynamics and corporeal metabolic blood quality assist the distinction between static and dynamic priapism. Normally, priapism is effectively treated with intracavernous vasoconstrictive agents or surgical shunting. However, when these two methods fail, subsequent treatment procedures are a matter for debate. Alternative options, such as intracavernous injection of methylene blue or selective penile arterial embolization, for the management of high and low flow priapism are described and a survey of current treatment modalities is presented.

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“…In order to avoid systemic complications, it is of outstanding importance to inject the agent into the fully erected corporeal cavernosa only (32). As no blood is retained in the penis, local administration of these agents may lead to such systemic complications as sustained hypertension up to 200 mmHg or cerebral bleeding (26,33). Alpha-agonists for oral administration may be taken into consideration, but hypertension and cardiac arrhythmia could assert a limiting effect (20).…”

Section: Conservative Treatment For Priapismmentioning

confidence: 99%

Priapism: etiology, pathophysiology and management

et al. 2003

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The understanding of erectile physiology has improved the prompt diagnosis and treatment of priapism. Priapism is defined as prolonged and persistent erection of the penis without sexual stimulation and failure to subside despite orgasm. Numerous etiologies of this condition are considered. Among others a disturbed detumescence mechanism, which may due to excess release of contractile neurotransmitters, obstruction of draining venules, malfunction of the intrinsic detumescence mechanism or prolonged relaxation of intracavernosal smooth muscle are postulated. Treatment of priapism varies from a conservative medical to a drastic surgical approach. Two main types of priapism; veno-occlusive low flow (ischemic) and arterial high flow (non-ischemic), must be distinguished to choose the correct treatment option for each type. Patient history, physical examination, penile hemodynamics and corporeal metabolic blood quality provides distinction between a static or dynamic pathology. Priapism can be treated effectively with intracavernous vasoconstrictive agents or surgical shunting. Alternative options, such as intracavernous injection of methylene blue (MB) or selective penile arterial embolization (SPEA), for the management of high and low flow priapism are described and a survey on current treatment modalities is given.

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Intrazerebrale Massenblutung nach intrakavernöser Metaraminol-Behandlung einer prolongierten Erektion

Cited by 9 publications

References 0 publications

SEXUAL DISORDERS Our experience in the treatment of priapism

SEXUAL DISORDERS Our experience in the treatment of priapism

New aspects in the treatment of priapism

Priapism: etiology, pathophysiology and management

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