Resolution of Recurrent Ischemic Priapism After Celiac Plexus Block: Case Report Evidence for its Neurogenic Origin?

Abstract

Introduction Recurrent ischemic priapism likely has a neurogenic basis for some clinical presentations. Aim To describe a phenomenon of resolved recurrent ischemic priapism in a patient following celiac plexus block for recurrent upper abdominal pain. Methods The case report profiled a 44-year-old Caucasian man who developed recurrent ischemic priapism after retroperitoneal surgery. He had failed multiple conventional interventions for his priapism. After he underwent a celiac plexus block for recurrent upper abdominal pain, his recurrent priapism episodes immediately stopped. Main Outcome Measures Clinical history regarding priapism occurrences. Results The patient obtained a resolution of his priapism after celiac plexus block, without recurrences at a 6-month follow-up assessment. Conclusions Celiac plexus block successfully led to resolution of recurrent ischemic priapism of probable neurogenic origin associated with spinal nerve outflow injury.

Rare disorders of penile erection

“…Neurotransmitters localized to central and peripheral nervous system levels may be operative in neuroregulatory mechanisms causing priapism, and it is plausible that proerectile neurotransmitter mechanisms are facilitated or antierectile neurotransmitter mechanisms are inhibited in the generation of this disorder. Evidence of autonomic neuronal derangements of spinal neural pathways in priapism case reports supports such neuropathologic mechanisms (50).…”

Recent Advances in the Medical and Surgical Treatment of Priapism

“…Burnett and Santiago [35] report a case of a 44-year-old male patient who developed recurrent ischemic priapism associated with upper abdominal pain after retroperitoneal surgery. His priapism recurred despite several conventional interventions, so a celiac plexus block was performed.…”

“…The block likely corrected some dysfunctional erection neuroregulatory mechanism in this patient, as it is understood to exert a sympathetic axis neurolysis. The authors concluded that celiac plexus block successfully led to the resolution of recurrent ischemic priapism of probable neurogenic origin, but that further investigation is required to affirm benefit [35].…”