Testosterone Induced Priapism in Kallmann’s Syndrome

Shergill, Iqbal; Pranesh, Nagarajan; Hamid, Rizwan; Arya, M; Anjum, Iqbal

doi:10.1097/01.ju.0000049199.37765.c9

Cited by 15 publications

(12 citation statements)

References 3 publications

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“…Several medical case reports have, even recently, documented priapism episodes in association with TRT in hypogonadal males [73–75]. However, these cases of priapism have all occurred with use of intramuscular testosterone esters that result in supra-physiologic levels of testosterone [76].…”

Section: Molecular Mechanisms Of Priapism Pathophysiology (Figure 1)mentioning

confidence: 99%

Molecular Pathophysiology of Priapism: Emerging Targets

Anele¹,

Morrison²,

Burnett³

2015

CDT

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Priapism is an erectile disorder involving uncontrolled, prolonged penile erection without sexual purpose, which can lead to erectile dysfunction. Ischemic priapism, the most common of the variants, occurs with high prevalence in patients with sickle cell disease. Despite the potentially devastating complications of this condition, management of recurrent priapism episodes historically has commonly involved reactive treatments rather than preventative strategies. Recently, increasing elucidation of the complex molecular mechanisms underlying this disorder, principally involving dysregulation of nitric oxide signaling, has allowed for greater insights and exploration into potential therapeutic targets. In this review, we discuss the multiple molecular regulatory pathways implicated in the pathophysiology of priapism. We also identify the roles and mechanisms of molecular effectors in providing the basis for potential future therapies.

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Section: Molecular Mechanisms Of Priapism Pathophysiology (Figure 1)mentioning

confidence: 99%

Molecular Pathophysiology of Priapism: Emerging Targets

Anele¹,

Morrison²,

Burnett³

2015

CDT

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“…However, there are also case reports in the literature on side effects after low-dose testosterone replacement therapy performed in boys and men with hypogonadism and in boys with CDGP [12,[15][16][17][18]. Arrigo et al [19] reported a 14-year-old boy who had suffered from high-flow priapism after the 2nd monthly injection of 25 mg depot testosterone.…”

Section: Discussionmentioning

confidence: 99%

“…Madrid Garcia et al [18] found a 14-year-old boy with CDGP with priapism after administration of 100 mg testosterone which required the punction-aspiration of the corpora cavernosa. Shergill et al [17] reported an 18-year-old patient with Kallmann's syndrome who developed low-flow priapism 10 days after the first injection of 100 mg testosterone.…”

Section: Discussionmentioning

confidence: 99%

Short-term adverse effects of testosterone used for priming in prepubertal boys before growth hormone stimulation test

Albrecht

Penger

Marx

et al. 2017

Journal of Pediatric Endocrinology and Metabolism

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Background: Despite the fact that priming with sex steroids in prepubertal children before growth hormone (GH) provocative tests is recommended, there is an ongoing controversial discussion about the appropriate age of the children, the drug used for priming, the dose and the period between priming and the GH test. Interestingly, there is no discussion on the safety of this procedure. To date, only little data have been available on the possible side effects of priming with testosterone. Methods: We analyzed the outcome in 188 short-statured prepubertal boys who had been primed with testosterone enanthate (n = 136: 50 mg; n = 51: 125 mg, and accidentally one boy with 250 mg) 7 days prior to the GH test. Serum testosterone levels were measured on the day of the GH test in 99 boys. Results: Overall, only five boys developed adverse side effects. Two boys (dose 125 mg) showed severe low-flow priapism and had to undergo decompression of the corpora cavernosa. One boy suffered from self-limiting priapism and testicular pain (dose 50 mg). Two patients reported testicular pain (each dose 50 mg). The single patient with 250 mg testosterone did not show any adverse effects. The total side effect rate was 2.7%. The serum testosterone levels of the boys with side effects were not different from the testosterone levels of the boys without any side effects. Conclusions: Parents and patients should be informed about the possible side effects of priming with testosterone such as priapism and testicular pain. However, the overall side effect rate is low. We found no correlation between the outcome and the testosterone dose used and/or the level of serum testosterone.

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“…Various drugs (Kogeorgos and de Alwis, 1986;Keoghane et al, 1990;Whalen et al, 1991;Fabin, 1993;Gitlin, 1994;van Hemert et al, 1995;Levenson, 1995;Javed, 1996;Berk and Acton, 1997;Bettocchi et al, 1998;Czachor et al, 1998;Rand, 1998;Vaidyanathan et al, 1998;Aoyagi et al, 1999;Brodie-Meijer et al, 1999;Compton et al, 2000;Samuel, 2000;Dodds et al, 2003;Shergill et al, 2003;Dogra et al, 2004;Lin et al, 2004;Touloupidis et al, 2004;Arrigo et al, 2005;King et al, 2005;Pahuja et al, 2005;Ichioka et al, 2006;Qazi et al, 2006;Vesta et al, 2006) have been implicated in causing priapism.…”

Section: Introductionmentioning

confidence: 98%

Priapism associated with atypical antipsychotic medications: a review

Sood

James

Bailon

2008

International Clinical Psychopharmacology

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Priapism defined as persistent, painful and prolonged penile erection, was previously thought to be associated only with the use of the older, conventional first generation or typical antipsychotic medications as well as some other medications, notably, trazodone. The mechanism of priapism associated with antipsychotics is not clear but is thought to be related to alpha-adrenergic blockage that is mediated by the alpha receptors in the corpora cavernosa of the penis. Atypical antipsychotics, also known as second-generation antipsychotics, owing to their favorable side effect profile, are being prescribed with increasing frequency and are not as frequently considered to cause priapism. Some case reports reporting this side effect with their use, however, are found. Pubmed and Ovid databases were searched to obtain all articles and case reports of antipsychotic drug-induced priapism. Key search words included 'priapism', 'antipsychotics' and 'drug-induced priapism'. References of all identified studies were also reviewed. A total of 50 publications were obtained. Most of the atypical antipsychotics have been reported to cause priapism. These cases have occurred in patients shortly after having been started on the antipsychotic medications as well as in those who have been on them for an extended period of time without modification in dosage, and have also occurred sometimes, with the addition of another antipsychotic, lithium or serotonin-specific reuptake inhibitor. Priapism has been documented with nearly all the atypical antipsychotic medications. It is, however, a rarely reported side effect and therefore, underappreciated. Priapism can cause irreversible erectile dysfunction and is a urologic emergency. Clinicians should monitor patients on these medications for this rare, yet significant side effect. Furthermore, caution must be used when adding new drugs to the regimen and patients should be closely monitored for this side effect. Educating patients about the risk of developing priapism would help increase awareness of the side effect and promote early reporting thereby, decreasing long-term morbidity.

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Testosterone Induced Priapism in Kallmann’s Syndrome

Cited by 15 publications

References 3 publications

Molecular Pathophysiology of Priapism: Emerging Targets

Molecular Pathophysiology of Priapism: Emerging Targets

Short-term adverse effects of testosterone used for priming in prepubertal boys before growth hormone stimulation test

Priapism associated with atypical antipsychotic medications: a review

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