Self-administered intraurethral chlorpromazine: An unusual cause of priapism

Jackson, Steven C.; Walker, James S.

doi:10.1016/0735-6757(91)90185-m

Cited by 17 publications

(7 citation statements)

References 38 publications

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“…Papaverine is associated with the highest incidence of priapism, followed by PGs and moxisylyte with the lowest incidence [15]. Transurethral alprostadil and chlorpromazine on rare occasions are reported to produce priapism [16,17]. Other causes include malignant penile infiltration [18] and neurogenic problems [19].…”

Section: Introductionmentioning

confidence: 99%

Low‐flow priapism: risk factors for erectile dysfunction

El‐Bahnasawy¹,

2002

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Objective To evaluate our policy of managing priapism for the success rate of the treatments, potency afterward, complications, and the risk factors responsible for erectile dysfunction in these patients. Patients and methods The study included 50 patients (mean age 37.1 years, range 22±66) with a diagnosis of priapism (1981±1999). Their records were reviewed; 35 patients were available for a long-term evaluation. Factors assessed were the duration of priapism, history of previous recurrent attacks, possible underlying causes (e.g. haematological disorders, medications or trauma), relation to sexual stimulation, pain, and any attempt at previous management. A complete blood screen and blood gases were assessed in corporal aspirates. Duplex ultrasonography was used in all impotent patients at their follow-up. Early and late complications were reviewed, and patients asked about their erectile function before priapism, and any recurrence. Results The median (range) duration of priapism was 48 (6±240) h; almost half the patients presented >48 h after the onset of priapism. Sixteen patients (32%) reported a history of previous recurrent attacks, of whom seven had a history of previous treatments. The main cause of priapism was idiopathic or intracavernosal injection with papaverine. All patients were initially treated by corporal blood aspiration and injection with ephedrine; if this failed or if the priapism was prolonged (>48 h) various shunts were used. The hospital stay was signi®cantly shorter among patients with papaverine-induced or brief priapism. In the long-term follow-up of 35 patients (mean 66.4 months, range 3±220) only 15 (43%) reported preserved erectile function, and this was more likely in patients with brief priapism (<48 h). Eight patients (23%) reported subsequent recurrent attacks of priapism; all were managed successfully as they presented shortly after their onset. Penile ®brosis was detected in 20 patients (57%), and was signi®cantly more common in those with prolonged priapism (>48 h) or from causes other than papaverine. The 20 impotent men evaluated by Doppler ultrasonography had severe echo-dense penile ®brosis and high end-diastolic velocities suggesting veno-occlusive incompetence in all except two. In ®ve men with shunts cavernosography showed extensive venous leakage irrespective of site of the shunt. MRI in ®ve patients with penile ®brosis showed heterogeneous areas of low signal intensity, corresponding with haemosiderin deposition and ®brosis. On univariate analysis the ®nal result of management (complete detumescence or not), the duration of priapism and the presence of penile ®brosis signi®cantly in¯uenced erectile function. On multivariate logistic regression only the ®rst remained signi®cant. Conclusions Low-¯ow priapism for >48 h, failure to maintain complete detumescence after management, and marked penile ®brosis during the follow-up are the most signi®cant risk factors responsible for erectile dysfunction, with failure to achieve complete detumescence the most detrimental.

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Section: Introductionmentioning

confidence: 99%

Low‐flow priapism: risk factors for erectile dysfunction

El‐Bahnasawy¹,

2002

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“…In addition, only one case reported priapism after self administered chlorpromazinte via transuretheral route [8].…”

Section: Discussionmentioning

confidence: 99%

Chlorpromazine induced priapism from a single dose: an unusual complication of antipsychotic agent

Ahmed¹,

Abdel‐latif²

2017

Russ Open Med J

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Priapism is considered as an unusual andrological emergency that requires urgent intervention. It is defined as prolonged penile erection (usually painful) for more than 4 hours not related to sexual excitation or stimulation. Several causes have been attributed to cause such condition including the use of psychotropic drugs as chlorpromazine. Only few case reports in literature have recorded priapism as a complication of administration of chlorpromazine, however most of them were due to overdose or prolonged administration for prolonged period or as an interaction with other drugs. Here, in this case report is about a 23 years old male presented to the emergency department with neglected priapism after administration of a single dose of chlorpromazine.

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“…Mutlu N, et al (1998) described two cases of priapism following orally administered chlorpromazine but in a rare 6 development . Jackson and Walker (1991) reported an unusual cause of priapism in a patient following self administered intra-urethral Chlorpromazine has remained invaluable as a major tranquilizer in the developing and low income countries because it is both affordable and readily available. Health care providers must not loose sight of the fact that it has a potential for priapism even when administered in the most unlikely and perhaps accidental route.…”

Section: Discussionmentioning

confidence: 99%

Priapism following Phenothiazine therapy: A Case Report and Review of the Literature

Akhigbe¹,

Uwadiae²

2009

Journal of Medicine and Biomedical Research

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Chlorpromazine, a phenothiazine antipsychotic, is an old generation major tranquilizer that has remained relevant in the management of psychosis despite the advent of the newer atypical brands. Priapism, an uncommon urological condition may result from the alphaadrenergic blocking action of antipsychotics. A 46 years old man developed priapism in the course of treatment with chlorpromazine. He was only able to achieve penile detumescence (subsidence or diminution of swelling or erection of the penis) after surgical intervention. Medical practitioners must regard this as a reminder of the possible risk of priapism with the use of chlorpromazine which remains a main line drug in the treatment of agitated patients in developing, low income countries. Caution must therefore be exercised particularly when combining drugs with high affinity for alpha-adrenergic blockade and patients' vulnerability considered whenever possible.

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Self-administered intraurethral chlorpromazine: An unusual cause of priapism

Cited by 17 publications

References 38 publications

Low‐flow priapism: risk factors for erectile dysfunction

Low‐flow priapism: risk factors for erectile dysfunction

Chlorpromazine induced priapism from a single dose: an unusual complication of antipsychotic agent

Priapism following Phenothiazine therapy: A Case Report and Review of the Literature

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