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Siregar S, Rulianov R, Ksatriapraja RA, Stefanus D. The role of angiotensin receptor blocker (losartan) on decreasing fibrotic process of corpora cavernosa in priapism model of wistar rats. F1000Res 2024; 11:831. [PMID: 38046538 PMCID: PMC10690033 DOI: 10.12688/f1000research.123040.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 12/05/2023] Open
Abstract
Background Priapism induces regulation of Transforming Growth Factor-β1 (TGF-β1) expression and collagen-type-1 deposition. This will replace the normal corpora cavernosa with fibrotic tissue which eventually resulted in erectile dysfunction. It is also known that the fibrosis process of corpora cavernosa is related to Renin-Angiotensin II System (RAS). Angiotensin II receptor blockers (ARB), especially losartan, inhibit the inflammation process and fibrotic tissue formation. This study evaluated the effect of losartan in reducing fibrosis in priapism by evaluating TGF-β1 and collagen-type-1 in cavernous tissue and determined the effect of losartan in preventing fibrosis in priapism model of Wistar rats assessed by the metavir score. Methods A total of eighteen male Wistar rats mean were divided into five groups. For the priapism models, we applied negative pressure on the penis to make an artificial erection to mimic the priapism process. The control groups were observed and the treatment groups were orally given losartan 15 mg/kg/day. Corpora cavernosa was harvested for TGF-β1 and collagen-type-1 measurement using an enzyme-linked immunosorbent assay (ELISA). The fibrotic tissue of each rat was then collected and assessed histopathologically with the metavir scoring system. Results Penile TGF-β1 concentration in the losartan-treated group was not significantly different on day 10 and day 28 of observation (p10=0,30; p28=0,17). Meanwhile, collagen-type-1 concentration was significantly lower compared to control group (p10=0,002; p28=0,01). There was a significant difference in metavir scores in rats that received losartan and those who did not (p<0,05). Conclusion Losartan could suppress the fibrosis process in the priapism model. It could decrease the collagen type 1 deposition during corpora cavernosa tissue regeneration. Based on the metavir score, the group receiving losartan therapy was better than the control group.
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Affiliation(s)
- Safendra Siregar
- Department of Urology, Universitas Padjadjaran, Bandung, 40161, Indonesia
| | - Rulianov Rulianov
- Department of Urology, Universitas Padjadjaran, Bandung, 40161, Indonesia
| | | | - Dicky Stefanus
- Department of Urology, Universitas Padjadjaran, Bandung, 40161, Indonesia
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Cita KC, Brureau L, Lemonne N, Billaud M, Connes P, Ferdinand S, Tressières B, Tarer V, Etienne-Julan M, Blanchet P, Elion J, Romana M. Men with Sickle Cell Anemia and Priapism Exhibit Increased Hemolytic Rate, Decreased Red Blood Cell Deformability and Increased Red Blood Cell Aggregate Strength. PLoS One 2016; 11:e0154866. [PMID: 27145183 PMCID: PMC4856257 DOI: 10.1371/journal.pone.0154866] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 04/20/2016] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To investigate the association between priapism in men with sickle cell anemia (SCA) and hemorheological and hemolytical parameters. MATERIALS AND METHODS Fifty-eight men with SCA (median age: 38 years) were included; 28 who had experienced priapism at least once during their life (priapism group) and 30 who never experienced this complication (control group). Twenty-two patients were treated with hydroxycarbamide, 11 in each group. All patients were at steady state at the time of inclusion. Hematological and biochemical parameters were obtained through routine procedures. The Laser-assisted Optical Rotational Cell Analyzer was used to measure red blood cell (RBC) deformability at 30 Pa (ektacytometry) and RBC aggregation properties (laser backscatter versus time). Blood viscosity was measured at a shear rate of 225 s-1 using a cone/plate viscometer. A principal component analysis was performed on 4 hemolytic markers (i.e., lactate dehydrogenase (LDH), aspartate aminotransferase (ASAT), total bilirubin (BIL) levels and reticulocyte (RET) percentage) to calculate a hemolytic index. RESULTS Compared to the control group, patients with priapism exhibited higher ASAT (p = 0.01), LDH (p = 0.03), RET (p = 0.03) levels and hemolytic indices (p = 0.02). Higher RBC aggregates strength (p = 0.01) and lower RBC deformability (p = 0.005) were observed in patients with priapism compared to controls. After removing the hydroxycarbamide-treated patients, RBC deformability (p = 0.01) and RBC aggregate strength (p = 0.03) were still different between the two groups, and patients with priapism exhibited significantly higher hemolytic indices (p = 0.01) than controls. CONCLUSION Our results confirm that priapism in SCA is associated with higher hemolytic rates and show for the first time that this complication is also associated with higher RBC aggregate strength and lower RBC deformability.
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Affiliation(s)
- Kizzy-Clara Cita
- Inserm UMR 1134, Université des Antilles, Pointe à Pitre, Guadeloupe
- Laboratoire d’Excellence du Globule Rouge (LABEX GR-Ex), COMUE Sorbonne Paris Cité, Paris, France
| | - Laurent Brureau
- CHU de Pointe-à-Pitre, Service d’Urologie, Pointe-à-Pitre, Guadeloupe
- Inserm, U1085—IRSET, Pointe-à-Pitre, Guadeloupe, France
| | - Nathalie Lemonne
- CHU de Pointe-à-Pitre, Unité Transversale de la Drépanocytose, Centre de référence maladies rares de la drépanocytose aux Antilles-Guyane, Pointe-à-Pitre, Guadeloupe
| | - Marie Billaud
- CHU de Pointe-à-Pitre, Unité Transversale de la Drépanocytose, Centre de référence maladies rares de la drépanocytose aux Antilles-Guyane, Pointe-à-Pitre, Guadeloupe
| | - Philippe Connes
- Inserm UMR 1134, Université des Antilles, Pointe à Pitre, Guadeloupe
- Laboratoire d’Excellence du Globule Rouge (LABEX GR-Ex), COMUE Sorbonne Paris Cité, Paris, France
- Institut Universitaire de France, Paris, France
- Université Claude Bernard Lyon 1, COMUE Lyon, Laboratoire LIBM EA 7424, Team “Vascular Biology and red blood cell”, Lyon, France
| | - Séverine Ferdinand
- Inserm UMR 1134, Université des Antilles, Pointe à Pitre, Guadeloupe
- Laboratoire d’Excellence du Globule Rouge (LABEX GR-Ex), COMUE Sorbonne Paris Cité, Paris, France
| | - Benoit Tressières
- Inserm, CHU de Pointe-à-Pitre, Centre d’Investigation Clinique Antilles Guyane CIC 14–24, Guadeloupe, France
| | - Vanessa Tarer
- CHU de Pointe-à-Pitre, Unité Transversale de la Drépanocytose, Centre de référence maladies rares de la drépanocytose aux Antilles-Guyane, Pointe-à-Pitre, Guadeloupe
| | - Maryse Etienne-Julan
- CHU de Pointe-à-Pitre, Unité Transversale de la Drépanocytose, Centre de référence maladies rares de la drépanocytose aux Antilles-Guyane, Pointe-à-Pitre, Guadeloupe
| | - Pascal Blanchet
- CHU de Pointe-à-Pitre, Service d’Urologie, Pointe-à-Pitre, Guadeloupe
- Inserm, U1085—IRSET, Pointe-à-Pitre, Guadeloupe, France
| | - Jacques Elion
- Laboratoire d’Excellence du Globule Rouge (LABEX GR-Ex), COMUE Sorbonne Paris Cité, Paris, France
- Inserm U 1134, Paris, France
| | - Marc Romana
- Inserm UMR 1134, Université des Antilles, Pointe à Pitre, Guadeloupe
- Laboratoire d’Excellence du Globule Rouge (LABEX GR-Ex), COMUE Sorbonne Paris Cité, Paris, France
- * E-mail:
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Yılmaz Y, Taken K, Atar M, Ergün M, Söylemez H. Protective effect of curcumin on priapism and ischemia-reperfusion injury in rats. Eur Rev Med Pharmacol Sci 2015; 19:4664-4670. [PMID: 26698266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE We aimed to identify the oxidative stress effects of the ischemic priapism on cavernosal tissues and to assess the biochemical and histopathological effects of curcumin in rats. MATERIALS AND METHODS 26 adult male Sprague Dawley rats were randomly divided into three groups. Group 1 (Control, n = 8): only penectomy was performed and 3 ml blood samples were obtained from the vena cava inferior (VCI). Group 2 (ischemia-reperfusion group; n= 8): penectomy was performed after 1 hour ischemic priapism + 30 min reperfusion and 3 ml blood samples were obtained from the VCI. Group III (IR + CURC group, n = 10): 200 mg/kg/day curcumin per orally before surgery for 7 days + penectomy after 1 hour ischemic priapism + 30 min reperfusion and 3 ml blood samples from the VCI. Total oxidant status (TAS), total antioxidant status (TAS) and paraoxonase (PON1) levels were measured. Tissue samples were investigated and scored histopathologically in terms of bleeding, edema and necrosis. RESULTS TOS levels were higher (p = 0.002), and TAS levels were lower (p = 0.001) in the IR group compared to the control group. As a result of curcumin treatment, TAS levels were increased (p = 0.003), and TOS levels were decreased (p = 0.004) in the IR + CURC group compared to the IR group. In the treatment group (IR + CURC) TAS and TOS levels were similar to levels in the control group. PON1 levels were increased with ischemia-reperfusion (p = 0.21) and decreased with curcumin treatment (p = 0.53), however these changes were not statistically significant. There was no significant difference in the effects of curcumin on histopathological changes. CONCLUSIONS This study showed that curcumin has preventive effects on oxidative stress parameters against ischemia-reperfusion injury.
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Affiliation(s)
- Y Yılmaz
- Department of Urology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
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Persec Z, Persec J, Rako D, Savić I, Kurelac T, Sović T, Buković D, Marinić DK. The use of color duplex ultrasound and magnetic resonance imaging in the dissolution of idiopathic recurrent priapism in patient with congenital penile curvature--a case report. Coll Antropol 2013; 37:305-308. [PMID: 23697290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Priapism, penile erection characterized as prolonged and devoid of sexual stimulation or excitement is a rare condition. It is critical to distinguish between low- and high-flow priapism, because the treatment algorithm differs markedly for these 2 conditions. The diagnosis is made clinically and confirmed with color Doppler ultrasonographic imaging (CDUS). We present a 21 year old men with high-flow priapism and left lateral congenital penile curvature. A duplex Winter shunt procedure was employed with corporeal irrigation of heparin solution and adrenalin solution instillation, but the priapism returned 12 hours after. Following several days slow instillation of phenilephrine or adrenaline solution accompanied by oral flutamide therapy resulted in complete detumescence. We used both CDUS and magnetic resonance imaging (MRI) before and after treatment of priapism. Although CDUS has been the primary modality for cross-sectional imaging of the penis, the superior soft-tissue contrast and spatial resolution afforded by MRI provide an opportunity to advance imaging evaluation of this organ.
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Affiliation(s)
- Zoran Persec
- University of Zagreb, Dubrava University Hospital, Department of Urology, Zagreb, Croatia.
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Donaldson JF, Davis N, Davies JH, Rees RW, Steinbrecher HA. Priapism in teenage boys following depot testosterone. J Pediatr Endocrinol Metab 2012; 25:1173-6. [PMID: 23329767 DOI: 10.1515/jpem-2012-0270] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 08/31/2012] [Indexed: 11/15/2022]
Abstract
Priapism is rare in children and may result in erectile dysfunction and sexual aversion behaviours. Testosterone therapy is commonly regarded as safe in children and is widely used in constitutional delay of growth and puberty, hypogonadism, hypospadias and micropenis. We report two cases of priapism in teenage boys with constitutional delay of growth and puberty after a change in the formulation of depot testosterone. One case required surgical intervention and the other was preceded by stuttering priapism. These cases illustrate the importance of patient and/or parent counselling before testosterone administration and consideration of lower doses in at-risk patients.
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Affiliation(s)
- James F Donaldson
- Department of Paediatric Urology, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK.
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Collins LL, Lee YF, Ting HJ, Lin WJ, Liu NC, Meshul CK, Uno H, Bao BY, Chen YT, Chang C. The roles of testicular nuclear receptor 4 (TR4) in male fertility-priapism and sexual behavior defects in TR4 knockout mice. Reprod Biol Endocrinol 2011; 9:138. [PMID: 21995792 PMCID: PMC3212810 DOI: 10.1186/1477-7827-9-138] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Accepted: 10/13/2011] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Successful reproductive efforts require the establishment of a situation favorable for reproduction that requires integration of both behavior and internal physiological events. TR4 nuclear receptor is known to be involved in male fertility via controlling spermatogenesis, yet its roles in regulating other biological events related to reproduction have not been completely revealed. METHODS Male TR4 knockout (TR4 -/-) and wild type mice were used for the sexual behavior and penile dysfunction studies. Mice were sacrificed for histological examination and corresponding genes profiles were analyzed by quantitative RT-PCR. Reporter gene assays were performed. RESULTS We describe an unexpected finding of priapism in TR4 -/- mice. As a transcriptional factor, we demonstrated that TR4 transcriptionally modulates a key enzyme regulating penis erection and neuronal nitric oxide synthese NOS (nNOS). Thereby, elimination of TR4 results in nNOS reduction in both mRNA and protein levels, consequently may lead to erectile dysfunction. In addition, male TR4 -/- mice display defects in sexual and social behavior, with increased fear or anxiety, as well as reduced mounting, intromission, and ejaculation. Reduction of ER alpha, ER beta, and oxytocin in the hypothalamus may contribute to defects in sexual behavior and stress response. CONCLUSIONS Together, these results provide in vivo evidence of important TR4 roles in penile physiology, as well as in male sexual behavior. In conjunction with previous finding, TR4 represents a key factor that controls male fertility via regulating behavior and internal physiological events.
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MESH Headings
- Animals
- DNA-Binding Proteins/genetics
- DNA-Binding Proteins/physiology
- Fertility
- Gene Expression Regulation, Enzymologic
- Genes, Reporter
- Male
- Mice
- Mice, Knockout
- Muscle, Smooth/growth & development
- Muscle, Smooth/metabolism
- Muscle, Smooth/pathology
- Muscle, Smooth/physiopathology
- Nitric Oxide Synthase Type I/genetics
- Nitric Oxide Synthase Type I/metabolism
- Nuclear Receptor Subfamily 2, Group C, Member 2/genetics
- Nuclear Receptor Subfamily 2, Group C, Member 2/physiology
- Penis/growth & development
- Penis/metabolism
- Penis/pathology
- Penis/physiopathology
- Priapism/metabolism
- Priapism/pathology
- Priapism/physiopathology
- Promoter Regions, Genetic
- RNA, Messenger/metabolism
- Recombinant Proteins/metabolism
- Response Elements
- Severity of Illness Index
- Sexual Behavior, Animal
- Transcriptional Activation
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Affiliation(s)
- Loretta L Collins
- George Whipple Lab for Cancer Research, Departments of Pathology, Urology, Radiation Oncology, and The Cancer Center, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Yi-Fen Lee
- George Whipple Lab for Cancer Research, Departments of Pathology, Urology, Radiation Oncology, and The Cancer Center, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Huei-Ju Ting
- George Whipple Lab for Cancer Research, Departments of Pathology, Urology, Radiation Oncology, and The Cancer Center, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Wen-Jye Lin
- George Whipple Lab for Cancer Research, Departments of Pathology, Urology, Radiation Oncology, and The Cancer Center, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Ning-Chun Liu
- George Whipple Lab for Cancer Research, Departments of Pathology, Urology, Radiation Oncology, and The Cancer Center, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Charles K Meshul
- Research Services, V.A. Medical Center and Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR 97239, USA
| | - Hideo Uno
- Wisconsin Regional Primate Research Center, University of Wisconsin, Madison, WI 53708, USA
| | - Bo-Ying Bao
- George Whipple Lab for Cancer Research, Departments of Pathology, Urology, Radiation Oncology, and The Cancer Center, University of Rochester Medical Center, Rochester, NY 14642, USA
- Sex Hormone Research Center and School of Pharmacy, China Medical University, Taichung, Taiwan
| | - Yen-Ta Chen
- George Whipple Lab for Cancer Research, Departments of Pathology, Urology, Radiation Oncology, and The Cancer Center, University of Rochester Medical Center, Rochester, NY 14642, USA
- Department of Urology, Chang Gung University, Kaohsiung 833, Taiwan
| | - Chawnshang Chang
- George Whipple Lab for Cancer Research, Departments of Pathology, Urology, Radiation Oncology, and The Cancer Center, University of Rochester Medical Center, Rochester, NY 14642, USA
- Sex Hormone Research Center and School of Pharmacy, China Medical University, Taichung, Taiwan
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Jiang H, Zhu XW, Shi SF, Xie LP, Teng XD, Chen ZD, Zheng XY. Malignant priapism secondary to testicular tumor. Chin Med J (Engl) 2009; 122:1839-1840. [PMID: 19781337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Affiliation(s)
- Hai Jiang
- Department of Urology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China
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Adetayo FO. Outcome of management of acute prolonged priapism in patients with homozygous sickle cell disease. West Afr J Med 2009; 28:234-239. [PMID: 20425738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Priapism is a persistent, often painful, purposeless penile erection, which amy or may not be associated with sexual desire, excitement stimulation, or intercourse. OBJECTIVE To present the outcome of management of acute prolonged priapism in patients with homozygous sickle cell disease. METHODS Fifty-four patients seen over a 20-year period were studied. Of these, 35 were treated surgically with Ebbehoj's cavernosa-glandular shunt while 19 were treated conservatively. The information documented for each patient included age, haemoglobin genotype, duration of priapism before treatment , time of onset, previous history of priapism and possible aetiological factors. RESULTS The age range 2.5-38 years with a mean of 20.56 + or - 9.33 years. The potency rate in those treated conservatively was 47.37% while it was 70.37% in those treated surgically. The potency rate in those treated conservatively was 47.37% while it was 70.37% in those treated surgically. The potency rate decreased with increasing duration of priapism before treatment. Those treated within three days had a significantly better outcome than those treated after three days. (chi(2)=4.2986, P=0.038). The potency rate also decreased with increasing age at onset but there was no statistically significant difference between the potency rate in the age groups. CONCLUSION Surgical treatment of acute prolonged priapism may be associated with a higher potency rate compared to conservative treatment. There is an inverse relationship between the potency rate and duration of priapism before treatment and age at onset of Priapism. Acute prolonged priapism is a common cause of impotence in patients with homozygous sickle cell disease.
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Affiliation(s)
- F O Adetayo
- Urology Unit, Department of Surgery, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
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Prabhakaran K, Jacobs BL, Smaldone MC, Franks ME. Stuttering priapism associated with hereditary spherocytosis. Can J Urol 2007; 14:3702-3704. [PMID: 17949526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Stuttering priapism is a clinical phenomenon that occurs commonly in certain patient populations, including sickle cell anemia and other hematologic dyscrasias. Although the mechanism is still not completely understood, treatment is focused on prevention of recurrence in the outpatient setting, and immediate detumescence and minimizing corporal fibrosis in the acute setting. We present a case of stuttering priapism in a 44 year-old male with hereditary spherocytosis and discuss the pathophysiology and clinical management of this entity.
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Affiliation(s)
- Karti Prabhakaran
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213-3232, USA
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Wen CC, Munarriz R, McAuley I, Goldstein I, Traish A, Kim N. Management of Ischemic Priapism with High‐Dose Intracavernosal Phenylephrine: From Bench to Bedside. J Sex Med 2006; 3:918-922. [PMID: 16942536 DOI: 10.1111/j.1743-6109.2005.00140.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Ischemic priapism is associated with cavernosal acidosis, which decreases the efficacy of adrenergic agonists. We determined the effect of acidosis on ligand dissociation from adrenergic receptors and assessed the efficacy of high-dose phenylephrine in treating patients with acute ischemic priapism. METHODS Dissociation rates of [3H]prazosin were determined at pH 7.2 and 6.9 in membrane preparations of rabbit penile cavernosal tissue. Vital signs were recorded from patients before injection, and at 1 minute and 5 minutes after injection of high-dose phenylephrine (1,000 mg q 5 minutes) for 17 consecutive cases of iatrogenic ischemic priapism that occurred after vascular assessment. We also provide two case reports of prolonged ischemic priapism successfully managed with high-dose phenylephrine. RESULTS Dissociation rates of [3H]prazosin were greater at pH 6.9 (K (-1) = 0.23/minute) than at pH 7.2 (K (-1) = 0.10/minute), suggesting decreased receptor affinity at acidic pH. Intracavernosal therapy with high-dose phenylephrine (mean dose 2,059 +/- 807 microg) was 100% effective with no adverse events or significant changes in vital signs. In addition, two patients with ischemic priapism for > or =36 hours were successfully treated with high-dose intracavernosal phenylephrine (mean dose 45,000 microg) without any adverse event. Both patients are currently potent. CONCLUSIONS Acidic pH may decrease the binding affinity of adrenergic ligands to their receptors. Phenylephrine at doses higher than previously reported may be necessary to overcome this decreased affinity in acidosis associated with ischemic priapism. High-dose intracavernosal phenylephrine administration is safe and effective in the management of ischemic priapism. Continuous cardiovascular monitoring is advised.
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Affiliation(s)
- C Charles Wen
- Department of Urology, Boston University School of Medicine, Boston, MA, USA.
| | - Ricardo Munarriz
- Institute for Sexual Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Iain McAuley
- Vancouver Island Health Authority, British Columbia, Canada
| | - Irwin Goldstein
- Institute for Sexual Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Abdulmaged Traish
- Department of Urology, Boston University School of Medicine, Boston, MA, USA; Department of Biochemistry, Boston University School of Medicine, Boston, MA, USA
| | - Noel Kim
- Department of Urology, Boston University School of Medicine, Boston, MA, USA
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13
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Affiliation(s)
- R Miocinovic
- Department of Urology, Medical College of Ohio, Toledo, OH 43614, USA.
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Sari I, Akar S, Secil M, Birlik M, Kefi A, Onen F, Celebi I, Akkoc N. Thrombosis and priapism in a patient with Henoch-Schonlein purpura. Rheumatol Int 2004; 25:472-4. [PMID: 16133584 DOI: 10.1007/s00296-004-0532-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2004] [Accepted: 08/13/2004] [Indexed: 10/26/2022]
Abstract
Henoch-Schönlein purpura (HSP) belongs to the category of systemic small-vessel vasculitis. Although long-term outcome is generally good, serious complications may occur. Thrombosis and priapism have been reported only as extremely rare complications of HSP. We describe a 37-year-old man who developed recurrent thrombotic events shortly after he had been diagnosed as having HSP. Although he had additional risk factors for thrombosis, such as prothrombin G20210A mutation and use of celecoxib before the last episode, temporal relation of the thrombotic attacks to the onset of HSP suggest that the disease itself may lead to a prothrombotic state. This case is the first adult HSP patient with priapism, which probably developed secondary to thrombosis of the dorsal penile vein.
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Affiliation(s)
- Ismail Sari
- Division of Rheumatology, Department of Internal Medicine, Dokuz Eylul University School of Medicine, 35340, Inciralti, Izmir, Turkey.
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Affiliation(s)
- Sefa Resim
- Department of Urology, KSU Medical School, Kahramanmaras, Turkey.
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Minardi D, Milanese G, Galosi AB, Donatelli G, Muzzonigro G. Persistent priapism and histological modifications of the erectile tissue. Two case reports. Arch Ital Urol Androl 2004; 76:97-9. [PMID: 15270424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
Prolonged veno-occlusive priapism is associated with a high risk of fibrosis of the corpora and impotence. We present 2 cases of prolonged low-flow priapism who came under our observation more then 72 hours after the onset of priapism. The first case was a 51-years old man in which the aethiology of priapism was cauda equina compression by a L4-L5 discal haernia, not recovered after surgical decompression. The second case was a 23-years old man suffering of painful priapism lasting for more than 7 days due by abuse of cocaine, alcohol and psychopharmaceuticals. In both cases drainage and irrigation of the corpora followed by injection with an alpha-agonist agent has been insufficient. Detumescence has been obtained with shunt procedure and compressive bondage. The biopsy of the corpora cavernosa showed fibrosis.
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Affiliation(s)
- Daniele Minardi
- Institute of Urology Polytechnic University of the Marche Region, Ancona, Italy
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Pushkar' DI, Shcheplev PA, Epifanova EA. [Diagnosis and therapy of different types of priapism]. Urologiia 2004:45-9. [PMID: 15199815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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18
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Ateş A, Aydintuğ OT, Düzgün N, Yaman O, Sancak T, Omür ND. Behçet's disease presenting as deep venous thrombosis and priapism. Clin Exp Rheumatol 2004; 22:107-9. [PMID: 15005013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Behçet's disease (BD) is a multi-system inflammatory disorder which may involve the vascular system. Currently, it is general practice to use the International Study Group (ISG) criteria for the diagnosis of BD. However, even though vascular involvement may be seen in one-fourth to one-half of BD patients, and occasionally is the presenting and only manifestation of BD, large vessel disease is not included among the ISG criteria. In this report we describe a patient who had deep venous thrombosis and priapism, but who does not fulfill ISG criteria for the diagnosis of BD.
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Affiliation(s)
- A Ateş
- Departments of Clinical Immunology and Rheumatology, Ankara University Faculty of Medicine, Ankara, Turkey.
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19
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Dewerchin M, Van der Elst L, Singh I, Grailly S, Saint-Remy JM, Collen D, Jacquemin M. Inhibition of factor VIII with a partially inhibitory human recombinant monoclonal antibody prevents thrombotic events in a transgenic model of type II HBS antithrombin deficiency in mice. J Thromb Haemost 2004; 2:77-84. [PMID: 14717970 DOI: 10.1111/j.1538-7836.2004.00524.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Venous thromboembolic disease is a major cause of morbidity and mortality, necessitating antithrombotic therapy. A human monoclonal anti-factor (F)VIII antibody, LCL-mAb-LE2E9, produced by a lymphoblastoid cell line derived from a hemophilia A patient with inhibitor to wild-type but not mutant self FVIII, was previously reported to achieve efficient inhibition of thrombosis in an experimental vena cava thrombosis model in mice. Here, the antithrombotic efficacy of a recombinant DNA-derived version of this anti-FVIII antibody (rec-mAb-LE2E9) was tested in mice which carry a type II heparin binding site antithrombin deficiency mutation and display spontaneous chronic thrombosis in several sites including the penile vein of sexually active males. The recombinant anti-FVIII antibody (100 microg, repeated after 3 days) prevented thrombotic priapism in all treated males, whereas all control animals treated with saline (group of four animals) developed priapism within 6 days after mating (P < 0.05 for treated vs. saline). The rec-mAb-LE2E9 and the original LCL-mAb-LE2E9 were equally effective (five and seven males/group, respectively). These results confirm that FVIII inhibition represents a potent antithrombotic strategy, and show that both LCL-mAb-LE2E9 and rec-mAb-LE2E9 efficiently prevent thrombosis in a physiological model representative of thrombosis in patients with a severe prothrombotic risk.
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Affiliation(s)
- M Dewerchin
- Center for Transgene Technology and Gene Therapy, VIB, KULeuven Campus Gasthuisberg, Leuven, Belgium.
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20
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Abstract
Priapism is a rare urologic emergency in pediatric population. It is usually a consequence of sickle cell disease. Leukemia is another important cause of priapism in children. We present a case of priapism associated with an acute pulmonary infection. To our knowledge, this is the second case describing this association. In the other reported case, pulmonary infection was related to Mycoplasma Pneumoniae. The hypothesis is that infection with Mycoplasma Pneumoniae can produce a hypercoagulable state, especially in selected areas of the circulation.
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Affiliation(s)
- H Sibai
- Service de chirurgie viscérale pédiatrique, hôpital d'Enfants, CH Ibn Rochd, Casablanca, Maroc.
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21
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Rogers L, López A, Gillis A. Priapism secondary to penile metastasis in a dog. Can Vet J 2002; 43:547-9. [PMID: 12125187 PMCID: PMC341944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
A 4-year-old, male Newfoundland cross was presented for lethargy, anorexia, and dysuria. The main clinical finding was an enlarged and painful prostate gland. While the dog was hospitalized, priapism developed. Following euthanasia, microscopic examination revealed that a carcinoma involving both bladder and prostate gland had widely metastasized to the penile vasculature.
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Affiliation(s)
- Laura Rogers
- Department of Pathology and Microbiology, Atlantic Veterinary College, University of Prince Edward Island, 550 University Avenue, Charlottetown, Prince Edward Island C1A 4P3
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22
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Pegios W, Rausch M, Balzer JO, Wolfram M, Bentas W, Jonas D, Vogl TJ. MRI and color-coded duplex sonography: diagnosis of partial priapism. Eur Radiol 2002; 12:2532-5. [PMID: 12271395 DOI: 10.1007/s00330-001-1199-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2001] [Revised: 09/07/2001] [Accepted: 09/24/2001] [Indexed: 10/25/2022]
Abstract
A case of partial priapism is reported diagnosed by contrast-enhanced MR imaging and color-coded duplex sonography. Follow-up examinations after 4 weeks and 3 months were performed. According to the results of color-coded duplex sonography and MRI, a partial priapism with development from the subacute stage to a fibrous residuum after spontaneous lysis was diagnosed. There are only very few cases of partial priapism reported in the literature and this is the first case report that demonstrates diagnosis and follow-up both by color-coded duplex sonography and contrast-enhanced MR imaging.
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Affiliation(s)
- W Pegios
- Department of Radiology, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
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23
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Abstract
We report the cases of 2 patients with partial segmental priapism. The patients presented with pain, a perineal mass, and proximal segmental corporal thrombosis. Treatment consisted of a proximal corpus cavernosal-spongiosum shunt. Diagnostic considerations, literature review, and treatment options are discussed.
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Affiliation(s)
- J H Lewis
- Department of Urology, Henry Ford Hospital, Detroit, Michigan, USA
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24
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Russo P. Urologic emergencies in the cancer patient. Semin Oncol 2000; 27:284-98. [PMID: 10864217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Urologic emergencies are common in the cancer patient and relate mainly to complications of bladder hemorrhage, upper or lower urinary tract obstruction, urinary tract infection, and priapism. Hemorrhagic cystitis is commonly due to bladder injury from radiation therapy, viral infection, or metabolites of chemotherapeutic agents. Treatments aimed at ameliorating the effects of theses metabolites, such as mesna and intravenous (IV) hydration, coupled with cystoscopy, evacuation of clots, and formalin instillation, have given clinicians an effective means of avoiding exsanguinating hemorrhage from the bladder. Malignant ureteral obstruction is an ominous sign in the cancer patient and may be due to tumor compression, retroperitoneal adenopathy, or direct tumor invasion. The endourologic procedures of ureteral stenting and percutaneous nephrostomy are effective means of palliation; however, complications of infection, stent obstruction, and stent migration can result in hospital admission and a decline in quality of life. Median survival for patients with malignant ureteral obstruction is less than 7 months, regardless of the tumor of origin. Bladder outlet obstruction leading to urinary retention can be due to mechanical factors involving the bladder neck or prostate, or to a breakdown in the neurophysiologic function of the bladder. Every attempt is made to avoid surgical intervention or the placement of chronic in-dwelling catheter in these often debilitated patients. Patients are often effectively treated with a variety of pharmacologic agents, such as alpha-adrenergic receptor blockers or by the initiation of chronic intermittent catheterization. Urinary tract infections are particularly dangerous in neutropenic and bone marrow transplant patients, with bladder catheters the most common portal entry. The colonization and later infection by resistant nosocomial organisms, such as Pseudomonas aeruginosa and Candida albicans, can rapidly lead to life-threatening sepsis. On rare occasions, emergency surgical intervention with adequate open drainage or nephrectomy is required to control such infections. Priapism can be caused by hematologic malignancy with hypercoagulation, metastatic disease involving the corpora cavernosa with thrombosis of the venous outflow from the penis, or rarely from intracavernous injections used for the treatment of impotence. If effective treatment exists for the primary tumor, improvement or resolution of the state of priapism may occur. Radiation therapy may be required to decrease the pain associated with malignant priapism, but surgical shunting procedures are rarely effective.
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Affiliation(s)
- P Russo
- Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA
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25
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Colombo F, Lovaria A, Saccheri S, Pozzoni F, Montanaris E. Arterial embolization in the treatment of post-traumatic priapism. Ann Urol (Paris) 1999; 33:210-8. [PMID: 10417850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Priapism is a prolonged penile erection not associated with sexual arousal. Two types of priapism have been described: the more common one is the "veno-occlusive" priapism and can be frequently observed as the consequence of an intracavernosal injection of vaso-active drugs for the treatment of erectile dysfunction. The less common type of priapism is known as "high flow" priapism and usually follows perineal or direct penile trauma. The clinical presentation in case of high flow priapism is quite typical: hystory of recent penile or perineal trauma followed, by the onset of a painless, incomplete and constant erection of the penis. A color-flow Doppler sonogram should be performed as first diagnostic step: this examination allows to identify the presence of patent cavernous arteries and prominent venous drainage with focal area of high flow turbulence along the pathway of one or both the cavernous arteries. An arterial blood sample taken from the corpora will confirm the diagnosis. At first, conservative therapeutical attempts can be suggested, with mechanical external compression of the perineum, the use of ice packs, corporeal aspiration and irrigation with saline. Besides, intracorporeal administration of alpha-agonists and methylene blue should be performed. Unfortunately, these conservative measures often result unsuccessful, and more invasive approaches must be considered. The radiological superselective transcatheter embolization of the proximal artery supplying arterial-lacunar fistula should be the present treatment of choice in these cases of high-flow priapism refractory to conservative and medical treatments. The first successful management of high flow priapism by selective arterial embolization was reported by Wear and coworkers in 1977. Autologous clots and gelatine sponge have been extensively used and become very popular as the embolic agent. More recently, platinum microcoils have been proposed with the aim to achieve more precise and selective embolization. In our single-case-experience on the treatment of high flow priapism by arterial embolization, we used the recently introduced tungsten microcoils. At the time of the follow-up, 2 months later, patient reported satisfactory intercourse with an approximately 75% of penile rigidity. By comparison with microsurgical ligature of the damaged vessel, selective embolization is, at least theoretically, a less invasive procedure, particularly with reference to the trauma caused to the erectile tissue. High-flow priapism is a fairly rare urological pathology which does not require immediate and emergency treatment (as is the case, instead, with venous-occlusive priapism), since the risk of post-ischaemic fibrosis is excluded thanks to the fact that oxygen is supplied to the cavernous tissue. Once the diagnosis has been established with certainty, therefore, the specialist has the necessary time at disposal to arrange for the most appropriate therapeutic steps. When, as is frequently the case, conservative measures prove ineffective, the current treatment of choice for cases of fistula of the cavernous artery would appear to be superselective embolization of the artery, provided same can be performed at specialized centres and by experienced personnel.
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Affiliation(s)
- F Colombo
- Institute of Urology, Ospedale Maggiore I.R.C.C.S., Milano, Italy
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26
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Rojas B, Cabrera ME, Kliwadenko W, Avilés JJ. [Priapism in a patient with chronic myeloid leukemia]. Rev Med Chil 1998; 126:978-80. [PMID: 9830750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Priapism is a rare complication of hematological diseases. Among leukemia, it is most frequently seen in patients with chronic myeloid leukemia, due to the high leukocyte counts that these patients achieve. We report a 22 years old male who presented with a priapism lasting more than 24 hours. Thirty six hours after admission and subsequent to a leukopheresis, penile relaxation was obtained. Despite good hematological response to therapy, an extensive penile and uretral necrosis, associated to an Acinetobacter infection, ensued between the fourth and fifth day of admission, that required surgical treatment.
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Affiliation(s)
- B Rojas
- Departamento de Medicina, Universidad de Chile, Santiago
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27
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Abstract
Priapism (persistent and painful erection) is an uncommon disorder in cats and dogs. This report describes the clinical and pathological features of seven cases of priapism in cats. Six of the cases were Siamese cats, and in four of them the priapism developed after attempted mating with an oestrus female, despite three of them having been neutered. Five cats were treated by perineal urethrotomy, which was successful in four. In five of the six amputated specimens, thrombosis of the corpus cavenosum was evident.
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Affiliation(s)
- D A Gunn-Moore
- Department of Clinical Veterinary Science, University of Bristol Veterinary School, Langford
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28
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Jam M, Datta NS, Askari A. An unusual case of priapism. J Natl Med Assoc 1993; 85:473-4. [PMID: 8366540 PMCID: PMC2571870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A case of sickle cell disease with 63 documented episodes of priapism that were managed medically is presented. The case is very unusual because of the fact that despite so many episodes of priapism, he did not lose sexual potency. On the contrary, over a period of time, his penis hypertrophied. To the best of our knowledge, this is the first such case with so many episodes of priapism reported in the English literature. We present a hypothesis for such unusual occurrence.
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Affiliation(s)
- M Jam
- Department of Surgery, King-Drew Medical Center, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059
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29
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Yokoi K, Miyazawa N, Muraki J, Nakazono M, Imura G, Shimamura K. Penile metastasis from lung cancer. Jpn J Clin Oncol 1992; 22:297-9. [PMID: 1434028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
A case of metastatic tumor of the penis from lung cancer is reported. The patient, who had received a right pneumonectomy 17 months previously for a squamous cell carcinoma of the lung, complained of urinary retention and painful erection of the penis. He underwent an emergency suprapubic cystostomy. Twenty days after the procedure, he died of disseminated lung carcinoma. The autopsy demonstrated massive metastasis to the penis from squamous cell carcinoma of the lung. Penile metastasis from lung cancer is a very rare condition and only 14 cases of this secondary carcinoma have been reported.
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Affiliation(s)
- K Yokoi
- Division of Thoracic Diseases, Tochigi Cancer Center, Utsunomiya
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30
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Lakhanpal S, Lie JT, Karper RE, Anderson LE, Cohen SB, Fleischmann RM. Priapism as a manifestation of isolated genital vasculitis. J Rheumatol 1991; 18:902-3. [PMID: 1895273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Vasculitis may affect virtually any organ system in the body. We describe a patient who presented with priapism due to isolated genital vasculitis. This responded promptly to oral corticosteroids. In patients presenting with priapism, a possible underlying vasculitis should be considered in the differential diagnosis; the treatment for this may be nonsurgical.
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31
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Abstract
A large series of patients was treated for impotence with intracorporeal injections of papaverine and phentolamine with no major complications and no deaths reported. We report on a 45-year-old black man with advanced multiple sclerosis who died after such therapy. When the first self-administered injection of phentolamine and papaverine failed to produce an adequate erection the patient injected a second dose that resulted in priapism and death of massive pulmonary embolism.
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32
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Teggi A, Della Rocca C, Traditi F, Lanzalone CM, De Rosa F. [Ulcerative colitis, thromboses of the cavernous sinuses and prostatic plexus and acute necrotizing hemorrhagic leukoneuraxitis: a case report of a syndromal association]. Medicina (Firenze) 1990; 10:286-91. [PMID: 2079881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The authors describe a case of ulcerative colitis initially complicated by priapism due to cavernous sinus thrombosis and by prostatic plexus thrombosis and, subsequently, by a fatal acute necrotizing hemorrhagic leukoencephalitis. This complex and, apparently, until now unreported association supports the view that ulcerative colitis is the expression of a systemic disease. It also raises important pathogenetic problems which are discussed in connection with the vascular complications of ulcerative colitis reported in the literature.
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Affiliation(s)
- A Teggi
- II Cattedra di Malattie Infettive, Università di Roma La Sapienza, Policlinico Umberto I
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33
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34
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Takamura S, Suzuki Y, Hiei T, Shimada H, Nakashima N, Tanaka J, Miyake K, Mitsuya H. [A case of priapism caused by disseminated intravascular coagulopathy]. Hinyokika Kiyo 1987; 33:453-7. [PMID: 3618417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A case is presented of priapism resulting from disseminated intravascular coagulopathy (DIC), which was diagnosed by pathological studies of the amputated penis and skin biopsy. To our knowledge, this is the first case reported in Japan. This 72-year-old-man visited a hospital complaining of fever and cough, and was administrated for treatment of bronchitis and liver cirrhosis. A few days after admission, multiple purpura with edema and pain appeared over the skin regions on the bilateral knee joint, foot joint and upper extremities. A week after purpura appeared, priapism began. Regardless of irrigation and aspiration of corpora cavernosa and glans-cavernosa-fistula creation, penile necrosis developed. We had to perform penile amputation. The pathology of the amputated penis and skin, and blood coagulative examination suggested that DIC resulted in priapism. DIC was controllable by the use of FOY and heparin. He was discharged and is an outpatient.
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35
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Abstract
The ultrastructure of erectile tissue from the corpora cavernosa penis of patients suffering from stasis priapism and high-flow priapism has been studied. Trabecular interstitial edema was confirmed as the first reaction of the tissue to the hemodynamic impairment. At the cellular level trabecular smooth muscle cells were found to be the first affected by the altered environmental conditions. Their reaction consisted of structural and functional transformation to fibroblast-like cells. Severe cellular damage and widespread necrosis were not seen in high flow priapism; such damage existed in stasis priapism, but only when the priapic episode lasted more than 24 hours. Blood clot formation within the cavernae and destruction of the endothelial lining occurred in stasis priapism lasting over 48 hours. At this time trabecular inflammation became conspicuous and most of the smooth muscle cells were either transformed to fibroblast-like cells or had undergone necrosis. This stage was not reached in high flow priapism, a fact supporting the view that high flow priapism is a more benign and prognostically more favorable form of priapism. Massive smooth muscle cell transformation and the loss of contractile trabecular elements may play an important role in the evolution of irreversible erectile failure following stasis priapism persisting longer than 24 hours.
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36
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Abstract
During the 8 years since inception of a home total parenteral nutrition program in 35 male patients 2 suffered priapism related temporally to the weekly intravenous infusion of 20 per cent fat emulsion. Fat emulsions have been shown to cause hypercoagulability, capillary thrombosis and fat embolus in in vivo and in vitro experiments. Autopsies of patients treated with intravenous fat emulsion have revealed capillary engorgement and fat embolus with associated organ infarction. We postulate that fat emulsions may cause priapism in these patients. Because of the more frequent occurrence of priapism in this small subset of patients we now recommend that 1) patients be informed of this potential complication before hyperalimentation is begun, 2) the less concentrated 10 per cent emulsion should be used twice weekly, rather than the 20 per cent emulsion weekly, and should be infused during at least 4 hours, and 3) the fat emulsion should be added to other components of the intravenous regimen, when possible, to dilute the fat and prolong its administration time.
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37
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Maeyama T, Uchida T, Matsuda S, Satoh T, Umino M, Shichishima T, Kariyone S, Yoshida H. [Two cases of priapism complicating chronic myeloid leukemia. Chronic phase and blastic crisis after splenectomy]. Rinsho Ketsueki 1982; 23:1907-11. [PMID: 6962918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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38
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39
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Roa Rico M, Roa Luzuriaga M. [Partial priapisms. Proximal priapism. Report of a case]. ARCH ESP UROL 1981; 34:297-300. [PMID: 7294904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
A very rare form of priapism in which the disorder is located in a localized area of the erectile tissue of the penis is presented. We consider this to be the first in Spanish literature and the fifth in the world. According to the review carried out, the most frequent etiology is traumatic, although the history of some cases is vague. Attention is drawn to the diagnosis, and therapy, which was successful in every case.
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40
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Abstract
A case of penile gangrene following priapism is reported. The 13 previously reported cases in the literature are reviewed. Avoidance of pressure dressing, local infection, and the use of urethral catheter should probably prevent this serious complication.
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41
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Abstract
We report the third documented case of partial priapism. The proximal right corpus was distended and separated from the distral flaccid corpus by a transverse membrane. Histologic examination revealed the obstructing lesion to be owing to thrombosis of vascular erectile tissue probably secondary to trauma. Excision of this membrane promptly cured the condition.
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42
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Borchers TM, Barnes DR. Priapism - a surgical emergency. S Afr Med J 1980; 57:674-6. [PMID: 7376036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Priapism is a surgical emergency, and a glandular cavernous shunt is good emergency treatment. The technique is simple, easy and quick, can be performed under local anaesthesia if necessary, and has a good chance of success; should it fail or the priapism recur, a more formidable shunt may be performed.
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43
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Abstract
A sixty-five-year-old white man presented with sudden onset of painful, priapism. Review of pathologic specimens at the time of surgical decompression revealed massive amyloid infiltration. Purpura, organ enlargement, gastrointestinal bleeding, and congestive heart failure developed subsequently. Postmortem examination revealed widespread amyloidosis. To our knowledge this is the first report of amyloidosis presenting with priapism.
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44
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Dutta TK, Purohit OP, Vaidyanathan V, Gupta BD, Rao MS. Radiation therapy of priaprism complicating chronic myeloid leukaemia--review and report of a case. Indian J Cancer 1979; 16:90-3. [PMID: 295275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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45
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Winter CC. Priapism. Urol Surv 1978; 28:163-6. [PMID: 751308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Since priapism often leads to impotence immediate therapy should be given with few exceptions (patients with sickle cell disease, neoplasm and infections). A careful history and a search for the etiology are important. The physician should protect himself against legal retribution by obtaining the patient's signature on an informed and witnessed consent to treat.
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46
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Abstract
A patient with an unusual form of priapism is described. Only the corpora cavernosa proximal to the suspensory ligament were erect. A well defined membrane was found in each corpus cavernosum at the penoscrotal junction, separating turgid and flaccid erectile tissue. When these membranes were removed the erect proximal corpora drained into the flaccid distal corpora and the entire penis remained flaccid 6 weeks later.
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47
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Pochedly C, Mehta A, Feingold E. Priapism with hyperacute stem-cell leukemia. N Y State J Med 1974; 74:540-1. [PMID: 4522659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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48
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Lozano Lozano GB, Castañeda Pérez F. [Priapism of the clitoris. Report of a clinical case]. Rev Inst Nac Cancerol (Mex) 1970; 22:688-90. [PMID: 5531443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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49
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50
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