Review of Ischemic and Non-ischemic Priapism

Biebel, Mark; Gross, Martin; Munárriz, Ricardo

doi:10.1007/s11934-022-01096-8

Cited by 8 publications

(5 citation statements)

References 130 publications

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“…Recent and more thorough knowledge of the pathophysiological basis of priapism and the clear differentiation between the low flow veno-occlusive priapism and high-flow arterial priapism have significantly improved the diagnostic protocol for patients with priapism [22]. It is advocated therefore that treatment of the acute ischemic patient must be based on patient objectives, available resources, and clinician experience, as was the case in this patient being reported [4]. Consequently, a single pathway for managing the disorder of priapism condition is oversimplified and no longer appropriate.…”

Section: Discussionmentioning

confidence: 91%

“…The clinician in this study was faced with an unusual presentation, a surgical emergency, in a psychiatric ward, which initially challenged the competence and capacity of the available resources. It is a widely held evidence-based finding, that priapism is noted to be a challenging condition to manage for urologists since the etiology is often multi-factorial and the suggested treatment algorithms are based on small studies and expert anecdotal experience, perhaps due to the rarity of the disorder [4,23]. It can be associated with significant patient distress and sexual dysfunction if emergency care is not instituted early after the onset [24].…”

Section: Discussionmentioning

confidence: 99%

“…Priapism may occur at all ages, from newborn to the elderly, it can even occur in impotent patients, and the erectile state is limited to the cavernous bodies, not affecting the corpus spongiosum or the glans [3]. This emergency condition has different presentations, etiologies, pathophysiology, and treatment algorithms [4]. It has been reported that both vascular and neural mechanisms are implicated in the pathophysiology of priapism, but it is not clear which initiates the process [5].…”

Section: Introductionmentioning

confidence: 99%

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Chlorpromazine-Induced Priapism in A 22-Year-Old Undergraduate Managed Conservatively in A Psychiatric Setting

Uche,

Beatrice

2023

J Behav Health

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Introduction: Priapism which is a urological emergency caused by the use of antipsychotic drugs like Chlorpromazine, can occur at all ages, from newborn to the elderly, irrespective of dose, route of administration, intake duration, the etiology, and prior history of penile erections. Case Presentation: A 22-year-old Nigerian undergraduate, in one of the Universities in the South East, was referred on account of the use of cannabis, alcohol, and codeine, with an associated history of abnormal behavior, low mood, weepy spells, guilt feelings, and poor sleep. A diagnosis of Mental and Behavioral Disorder secondary to Polysubstance Dependence (Cannabis, Alcohol, Shisha, Codeine, Crack) with co-morbid Severe Depression with Suicidal ideations, was made. Investigations done included Complete blood count, Malarial parasite test and Widal test, Serum Electrolyte, Urea and Creatinine, Retroviral screening, and HBsAg. The patient after the first dose of Intramuscular Chlorpromazine developed a painful penile erection (Priapism), which changed the clinical picture. A referral made to a Urologist was declined, as he was recommending that the patient be referred, which was not possible in the immediate term. Ice packs were administered in the region of the penis, that there was reversal of the painful engorgement of the penis. The time between the onset of the side effect and resolution of the engorgement was 3 hours, which was within the golden hours allowed in order to avoid complications. Conclusion: This possibility of priapism due to antipsychotic use, and lessons from its conservative management, makes it imperative that physicians and patients, must be alert and knowledgeable about this life-threatening adverse drug reaction and this awareness would help in reducing priapism-related adverse sequelae.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Chlorpromazine-Induced Priapism in A 22-Year-Old Undergraduate Managed Conservatively in A Psychiatric Setting

Uche,

Beatrice

2023

J Behav Health

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“…The American Urology Association (AUA), the European Association of Urology (EAU), and the Sexual Medicine Society of North America (SMSNA) have published guidelines on the management of ischemic priapism in humans [ 1 , 31 , 32 ]. Three recent reviews have also been published [ 33 , 34 , 35 ]. Guidelines recommend a stepwise escalation of treatment beginning with conservative treatment before invasive treatment [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Stuttering Priapism in a Dog—First Report

Roux

Breuil

Branchereau

et al. 2022

Veterinary Sciences

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A 5-year-old recently castrated male Doberman dog presented for prolonged erection of one week’s duration with associated pain and dysuria. This was the fourth episode within a year. Each episode was associated with an unusual event, which was stressful for the dog. Castration performed two months prior to the final episode did not prevent recurrence. Due to tissue necrosis, penile amputation and urethrostomy had to be performed. The dog recovered fully. Prolonged erection that persists beyond or that is unrelated to sexual stimulation is called “priapism”. This term refers to the Greek god Priapus, a god of fertility, memorialized in sculptures for his giant phallus. In humans, depending on the mechanism involved, priapism is classified as nonischemic or ischemic. Because prognosis and treatment are different, priapism must be determined to be nonischemic or ischemic. Nonischemic priapism is a rare condition observed when an increase in penile arterial blood flow overwhelms the capacity of venous drainage; it is often associated with penile trauma, and does not require medical intervention. Ischemic priapism is associated with decreased venous return. In humans, ischemic priapism accounts for 95% of cases, the majority of which are idiopathic. Ischemic priapism is a urological emergency; simple conservative measures such as aspiration of blood from the corpora cavernosa and intracavernosal injection of an adrenergic agent are often successful. Stuttering priapism, also called recurrent or intermittent priapism, is a particular form of ischemic priapism reported in humans that is characterized by repetitive episodes of prolonged erections. Management consists of treating each new episode as an episode of acute ischemic priapism, and preventing recurrence with oral medications such as dutasteride and/or baclofen, gabapentin, or tadalafil. To the authors’ knowledge, this case is the first report of stuttering priapism in a dog.

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“…These complications can lead to the need for surgery and may result in long-term rectal dysfunction. Patients who have undergone surgical interventions for rectosigmoid ischemia may also be at increased risk of complications such as bleeding, infection, and anastomotic leakage [ 2 , [10] , [11] , [12] ]. The prognosis of rectosigmoid ischemia depends on the severity of the condition, the underlying cause, and the timely management of the condition.…”

Section: Introductionmentioning

confidence: 99%

A case report of transmural rectosigmoid ischemia in an elderly patient

Ebrahimi,

Arabi,

Dabiri

et al. 2023

International Journal of Surgery Case Reports

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Review of Ischemic and Non-ischemic Priapism

Cited by 8 publications

References 130 publications

Chlorpromazine-Induced Priapism in A 22-Year-Old Undergraduate Managed Conservatively in A Psychiatric Setting

Chlorpromazine-Induced Priapism in A 22-Year-Old Undergraduate Managed Conservatively in A Psychiatric Setting

Stuttering Priapism in a Dog—First Report

A case report of transmural rectosigmoid ischemia in an elderly patient

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