Patient Education Is Associated With Reduced Delay to Presentation for Management of Ischemic Priapism: A Retrospective Review of 123 Men

Dutta, Rahul; Matz, Ethan; Overholt, Tyler; Anderson, William B.; Deebel, Nicholas A.; Cowper, Matthew G; Terlecki, Ryan; Scarberry, Kyle

doi:10.1016/j.jsxm.2020.11.017

Cited by 5 publications

(5 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Based on these premises, it appears that, among the high-risk list of drugs here analysed, trazodone generated indeed the strongest SDR, whilst olanzapine and tadalafil seemed somewhat more prone to cause priapism vs. the other drugs of the database (except for trazodone). The propensity of trazodone to elicit priapism is already well documented in the literature [19][20][21]. Although a number of medications identified in this list may be prescribed by sexual medicine specialists, most of these drugs are typically prescribed by psychiatrists and primary care doctors.…”

Section: Discussionmentioning

confidence: 99%

Medications mostly associated with priapism events: assessment of the 2015–2020 Food and Drug Administration (FDA) pharmacovigilance database entries

et al. 2022

View full text Add to dashboard Cite

A range of drugs have a direct role in triggering ischaemic priapism. We aimed at identifying: a)which medications are associated with most priapism-reports; and, b)within these medications, comparing their potential to elicit priapism through a disproportionality analysis. The FDA Adverse Event Reporting System (FAERS) database was queried to identify those drugs associated the most with priapism reports over the last 5 years. Only those drugs being associated with a minimum of 30 priapism reports were considered. The Proportional Reporting Ratios (PRRs), and their 95% confidence intervals were computed. Out of the whole 2015-2020 database, 1233 priapism reports were identified, 933 of which (75.7%) were associated with 11 medications with a minimum of 30 priapismreports each. Trazodone, olanzapine and tadalafil showed levels of disproportionate reporting, with a PRR of 9.

show abstract

Section: Discussionmentioning

confidence: 99%

Medications mostly associated with priapism events: assessment of the 2015–2020 Food and Drug Administration (FDA) pharmacovigilance database entries

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The 10-year priapism experience: identifying clearer targets for intervention that the healthcare consequences of priapism have received little awareness despite priapism being considered one of the worst complications of sickle cell disease (4). Some of the largest studies include 100-200 priapism patients that each illuminate an important clinical aspect of priapism (management, prevention, erectile dysfunction outcomes), however more studies are needed to be able to understand the heterogeneity of this patient population (6)(7)(8).…”

Section: Original Articlementioning

confidence: 99%

“…Among those patients, 10 (29%) had a prior shunt completed. Consults who were transferred had an average duration of priapism of median 26 hours (IQR, 10-48) compared to consults who were not transferred [median 5.5 hours (IQR, [4][5][6][7][8]]. The majority of patients (75%) requiring an OR procedure were transferred patients.…”

Section: Urology Consults Cohortmentioning

confidence: 99%

The 10-year priapism experience: identifying clearer targets for intervention

Howland¹,

Daignault‐Newton²,

Blair³

2022

Transl Androl Urol

View full text Add to dashboard Cite

Background: There is a paucity of data on the clinical experience of priapism. Moreover, little work has explored differences in practice patterns between urologists and emergency medicine (EM) physicians. Our primary objective was to understand the priapism patient population and identify targets that may guide clinical translational efforts. Methods: A retrospective chart review was performed on two priapism datasets from June 2008-July 2018-one focused on patients managed by urology and another on patients managed exclusively by EM physicians. Primary areas of interest included the duration of priapism and acute interventions during the consultation. Time to presentation, prior interventions and evaluation was also documented.Results: Over the course of 10 years, there were 396 encounters for priapism in 95 unique patients.Urology was consulted 199 times in 83 unique patients and EM physicians managed 197 encounters in 15 unique patients. In the urology cohort, median duration of priapism was 6 hours, and 72% of patients required further intervention. For the EM cohort, median duration of priapism was 4 hours and 89% of patients required further intervention. Amongst all patients, nine patients presented 4 or more times for a total of 294 encounters.Conclusions: Urology and EM managed a similar number of encounters, but EM patients had a shorter duration of priapism. Understanding the role of the EM physician and the urologist can help tailor joint curriculum efforts for initial priapism management while focusing on more complex management for urology trainees. A small proportion of patients accounted for the majority of visits secondary to recurrent ischemic priapism indicating a need to target prevention of these episodes on an outpatient basis.

show abstract

“…1,8 An indi vid ual ' s inad e quate knowl edge of priapism, in addi tion to the shame and embar rass ment, may con trib ute to about 50 % of affected indi vid u als fail ing to seek med i cal inter ven tion or even dis cuss the com pli ca tion with their cli ni cians and rel a tives. 1,8,9 Thus, the lack of knowl edge of priapism may add to the underrecognition of the bur den in a clin i cal set ting. 9,10 We review the epi de mi ol ogy and patho bi ol ogy of priapism, along with mech a nis tic ther a peu tic approaches for sec ond ary pre ven tion of priapism in SCD.…”

Section: Introductionmentioning

confidence: 99%

“…1,8,9 Thus, the lack of knowl edge of priapism may add to the underrecognition of the bur den in a clin i cal set ting. 9,10 We review the epi de mi ol ogy and patho bi ol ogy of priapism, along with mech a nis tic ther a peu tic approaches for sec ond ary pre ven tion of priapism in SCD.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and treatment of priapism in sickle cell disease

2022

View full text Add to dashboard Cite

Ischemic priapism is a common but underrecognized morbidity affecting about 33% of adult men with sickle cell disease (SCD). The onset of priapism occurs in the prepubertal period and tends to be recurrent with increasing age. Significantly, priapism is associated with an unrecognized high burden of mental duress and sexual dysfunctions. The diagnosis of priapism is clinical. Many episodes of priapism will resolve spontaneously, but when an episode lasts longer than 4 hours, the episode is considered a urologic emergency requiring quick intervention with either corporal aspiration or shunt surgery. Only 3 randomized clinical trials (stilbesterol, ephedrine or etilefrine, and sildenafil) have been conducted for secondary priapism prevention in SCD. All 3 trials were limited with small sample sizes, selection biases, and inconclusive results after completion. The current molecular understanding of the pathobiology of priapism suggests a relative nitric oxide (NO) deficiency secondary to chronic hemolysis in SCD and associated phosphodiesterase type 5 dysregulation. We posit an increase in NO levels will restore the normal homeostatic relationship between voluntary erection and detumescence. Currently, 2 randomized phase 2 trials (1 double-blind, placebo-controlled trial and 1 open-label, single-arm intervention) are being conducted for secondary priapism prevention in men at high risk for recurrent priapism (NCT03938454 and NCT05142254). We review the epidemiology and pathobiology of priapism, along with mechanistic therapeutic approaches for secondary prevention of priapism in SCD.

show abstract

Patient Education Is Associated With Reduced Delay to Presentation for Management of Ischemic Priapism: A Retrospective Review of 123 Men

Cited by 5 publications

References 12 publications

Medications mostly associated with priapism events: assessment of the 2015–2020 Food and Drug Administration (FDA) pharmacovigilance database entries

Medications mostly associated with priapism events: assessment of the 2015–2020 Food and Drug Administration (FDA) pharmacovigilance database entries

The 10-year priapism experience: identifying clearer targets for intervention

Epidemiology and treatment of priapism in sickle cell disease

Contact Info

Product

Resources

About