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High-flow priapism in pediatric population: Case series and review of the literature. Actas Urol Esp 2021; 45:597-603. [PMID: 34688599 DOI: 10.1016/j.acuroe.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 05/02/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Priapism is a prolonged erection that lasts longer than four hours. It is a rare pathology in the pediatric population, with an estimation of 0.3-1.5 per 100,000 children per year. The diagnostic sequence includes clinical history, physical examination and penile Doppler ultrasound (PDUS). Puncture of corpora cavernosa is not always necessary to establish the differential diagnosis between high-flow and low-flow priapism. The treatment of choice in pediatric age is not well defined. PATIENTS AND METHODS Multicentric, retrospective and descriptive study including patients under 14 years with high-flow priapism between 2010 and 2020. LITERATURE REVIEW RESULTS A total of seven patients were diagnosed with high-flow priapism. None of them required puncture of the corpora cavernosa. Patients were treated with a conservative management, two patients required superselective arterial embolization due to persistent symptoms. CONCLUSIONS High-flow priapism is a very rare entity in pediatric age; therefore, knowing the proper diagnosis and management is crucial. Currently, penile doppler ultrasound is enough for diagnosis in most cases and allows obviating the use of blood gas analysis. Children should be initially treated with a conservative management, reserving embolization for refractory cases.
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Sarrió-Sanz P, Martínez-Cayuelas L, March-Villalba JA, López-López AI, Rodríguez-Caraballo L, Sánchez-Caballero L, Polo-Rodrigo A, Nakdali-Kassab B, Conca-Baenas MA, Gómez-Garberí M, Pacheco-Bru JJ, Perez-Seoane-Ballester H, Pérez-Tomás C, Gómez-Pérez L, Ortiz-Gorraiz MA, Serrano-Durbá A. High-flow Priapism in Pediatric Population: Case Series and Review of the Literature. Actas Urol Esp 2021; 45:S0210-4806(21)00095-4. [PMID: 34127286 DOI: 10.1016/j.acuro.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 04/15/2021] [Accepted: 05/02/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Priapism is a prolonged erection that lasts longer than four hours. It is a rare pathology in the pediatric population, with an estimation of 0.3-1.5 per 100,000 children per year. The diagnostic sequence includes clinical history, physical examination and penile Doppler ultrasound (PDUS). Puncture of corpora cavernosa is not always necessary to establish the differential diagnosis between high-flow and low-flow priapism. The treatment of choice in pediatric age is not well defined. PATIENTS AND METHODS Multicentric, retrospective and descriptive study including patients under 14 years with high-flow priapism between 2010 and 2020. LITERATURE REVIEW RESULTS A total of seven patients were diagnosed with high-flow priapism. None of them required puncture of the corpora cavernosa. Patients were treated with a conservative management, two patients required superselective arterial embolization due to persistent symptoms. CONCLUSIONS High-flow priapism is a very rare entity in pediatric age; therefore, knowing the proper diagnosis and management is crucial. Currently, penile doppler ultrasound is enough for diagnosis in most cases and allows obviating the use of blood gas analysis. Children should be initially treated with a conservative management, reserving embolization for refractory cases.
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Affiliation(s)
- P Sarrió-Sanz
- Servicio de Urología Hospital Universitario de San Juan de Alicante, Alicante, España; Sección de Urología Pediátrica Hospital Universitario y Politécnico la Fe de Valencia, Valencia, España.
| | - L Martínez-Cayuelas
- Servicio de Urología Hospital Universitario de San Juan de Alicante, Alicante, España
| | - J A March-Villalba
- Sección de Urología Pediátrica Hospital Universitario y Politécnico la Fe de Valencia, Valencia, España
| | - A I López-López
- Servicio de Urología Hospital Universitario de San Juan de Alicante, Alicante, España
| | - L Rodríguez-Caraballo
- Sección de Urología Pediátrica Hospital Universitario y Politécnico la Fe de Valencia, Valencia, España
| | - L Sánchez-Caballero
- Servicio de Urología Hospital Universitario de San Juan de Alicante, Alicante, España
| | - A Polo-Rodrigo
- Sección de Urología Pediátrica Hospital Universitario y Politécnico la Fe de Valencia, Valencia, España
| | - B Nakdali-Kassab
- Servicio de Urología Hospital Universitario de San Juan de Alicante, Alicante, España
| | - M A Conca-Baenas
- Sección de Urología Pediátrica Hospital Universitario y Politécnico la Fe de Valencia, Valencia, España
| | - M Gómez-Garberí
- Servicio de Urología Hospital Universitario de San Juan de Alicante, Alicante, España
| | - J J Pacheco-Bru
- Servicio de Urología Hospital Universitario de San Juan de Alicante, Alicante, España
| | | | - C Pérez-Tomás
- Servicio de Urología Hospital Universitario de San Juan de Alicante, Alicante, España
| | - L Gómez-Pérez
- Servicio de Urología Hospital Universitario de San Juan de Alicante, Alicante, España
| | - M A Ortiz-Gorraiz
- Servicio de Urología Hospital Universitario de San Juan de Alicante, Alicante, España
| | - A Serrano-Durbá
- Sección de Urología Pediátrica Hospital Universitario y Politécnico la Fe de Valencia, Valencia, España
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Posttraumatic Arterial Priapism Treated with Superselective Embolization: Our Clinical Experience and a Review of the Literature. Adv Ther 2019; 36:684-690. [PMID: 30684137 DOI: 10.1007/s12325-019-0875-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION To present 12 cases of arterial priapism treated by superselective embolization and propose our management algorithm for this condition. METHODS Between February 2013 and May 2018, 12 cases of arterial priapism caused by blunt trauma were treated by superselective embolization. The mean age of patients was 36 years (25-47 years). All of the patients had normal sexual capability before priapism (IIEF-5 scores 24-25). All patients were treated with superselective embolization after more than 3 weeks of simple conservative treatment had failed. All cases but one used a gelatin sponge as embolic agent. A microcoil was added in one case in which the gelatin sponge failed to occlude the pseudoaneurysm. After superselective embolization, ice pack and "observation" treatments continued. The sexual capability of the patients was evaluated by IIEF-5 scores at 6 months and 12 months postoperatively. RESULTS The mean follow-up period was 27.2 months (13-48 months). Three patients achieved complete detumescence immediately. Nine cases needed 2-17 days to return to a flaccid nonpainful state. No patient underwent a second embolization. The time needed to improve erectile function was from 7 days to 4 months. There has been no recurrence. Eleven patients treated with gelatin sponge have normal erectile function, while one patient treated with additional microcoil embolization had mild erectile dysfunction. CONCLUSION Superselective embolization of the fistula is an effective option for arterial priapism. Absorbable agents should be used. Superselective arterial embolization should be considered after 3 weeks of conservative treatment. Patients should undergo another 3 weeks of "observation" treatment before repeated intervention.
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Carvajal A, Benavides JA. Combination High Flow Priapism With Low Flow Priapism: Case Report. Sex Med 2018; 7:111-113. [PMID: 30522977 PMCID: PMC6377370 DOI: 10.1016/j.esxm.2018.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 09/21/2018] [Accepted: 10/04/2018] [Indexed: 11/29/2022] Open
Abstract
Introduction Priapism is defined as a persistent penile erection lasting longer than 4 hours and unrelated to sexual activity. It is one of the most common emergencies treated by urologists. Advances in understanding the pathophysiology of various types of priapism have led to targeted management strategies according to type of priapism. Aim The aims of this article is report the case of a 24-year-old man who was presented in the emergency department with a combination of high flow priapism with low flow priapism. Methods This case report documents the case of a patient who presented in the emergency department with a high flow priapism that then became to a ischemic priapism. Conclusion Priapism is one of the most common emergencies treated by urologists. Advances in understanding the pathophysiology of various types of priapism have led to targeted management strategies as was shown in our case. Carvajal A, Benavides JA. Combination High Flow Priapism With Low Flow Priapism: Case Report. Sex Med 2019;7:111–113.
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Mockford K, Weston M, Subramaniam R. Management of high-flow priapism in paediatric patients: a case report and review of the literature. J Pediatr Urol 2007; 3:404-12. [PMID: 18947783 DOI: 10.1016/j.jpurol.2007.01.202] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2006] [Accepted: 01/15/2007] [Indexed: 10/23/2022]
Abstract
Priapism is rare in the paediatric population and hence there is little consensus as to appropriate management strategies. This is a report of a case of high-flow priapism in a 9-year-old boy managed expectantly. A review of the literature found 52 previously published cases. This report highlights the diagnostic problems and examines the safety and effectiveness of expectant management in the paediatric population.
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Affiliation(s)
- Katherine Mockford
- Department of Paediatric Urology, Level 4 Gledhow Wing, C/o Nephrology Secretaries' Office, St. James' University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK
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Takao T, Osuga K, Tsujimura A, Matsumiya K, Nonomura N, Okuyama A. Successful superselective arterial embolization for post-traumatic high-flow priapism. Int J Urol 2007; 14:254-6. [PMID: 17430268 DOI: 10.1111/j.1442-2042.2007.01574.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report a case of high-flow priapism treated successfully with superselective embolization of the cavernous artery. An 18-year-old man presented to our hospital 12 days after having been struck in the perineum by the corner of a skateboard. Immediately after the injury, he suffered painless sustained incomplete erection. High-flow priapism was diagnosed on the basis of cavernosal blood gas analysis and color Doppler ultrasonography findings. Right internal pudendal arteriography showed blood pooling in the cavernosum as a result of a broken artery. We identified the precise position of the arterial-venous fistula and embolized it superselectively with gelatin sponge particles. The fistula disappeared completely. One year later, the patient's erectile function was completely restored, and there had been no recurrence of the priapism. According to the American Urological Association guidelines, conservative treatment should be attempted first for high-flow priapism. In our review of the literature, superselective arterial embolization could be an alternative treatment after more than 3 weeks of conservative treatment.
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Affiliation(s)
- Tetsuya Takao
- Department of Urology, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita, Osaka 565-0871, Japan.
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Rodríguez Tolrá J, Campaña Cuadrado JM, Ropero Valverde J, Ruiz Salas V, Franco Miranda E. Nuestra experiencia en el priapismo de alto flujo por fístula arterio-lacunar uni y bilateral. Actas Urol Esp 2007; 31:113-9. [PMID: 17645090 DOI: 10.1016/s0210-4806(07)73608-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To present our experience in both uni-and bilateral priapism, highlighting good results obtained with supraselective embolisation. MATERIAL AND METHODS We present 5 cases of high-flow priapism secondary to perineal trauma, with a mean age of 31 years (24-43 years). The mean time to presentation from the moment of the trauma was 18, 6 days (1-60 days). Diagnosis was confirmed through gasometry of the corpora cavernosa, penile Doppler ultrasound (2 cases) and selective arteriography of the pudendal artery. In all cases treatment was by supralective embolisation with gelatin sponge. In the two bilateral cases, embolisation was performed in the same act. RESULTS In the short-term was a recovery of flaccidity and in the long-term (3-4 months) a recovery of erection with no fibrotic sequelae of the corpora cavernosa. CONCLUSIONS Embolisation of the lacerated artery, in a single procedure in cases of bilateral lacerations, provides excellent results.
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Affiliation(s)
- J Rodríguez Tolrá
- Unidad de Andrología, Servicio de Urología, Hospital Univ. de Bellvitge, L'Hospitalet, Barcelona.
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Kadioglu A, Sanli O, Celtik M, Cakan M, Taskapu H, Akman T. Practical Management of Patients with Priapism. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.eeus.2006.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Cherian J, Rao AR, Thwaini A, Kapasi F, Shergill IS, Samman R. Medical and surgical management of priapism. Postgrad Med J 2006; 82:89-94. [PMID: 16461470 PMCID: PMC2596691 DOI: 10.1136/pgmj.2005.037291] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Priapism is a pathological condition of penile erection that persists beyond, or is unrelated to, sexual stimulation. Pathologically and clinically, two subtypes are seen-the high flow (non-ischaemic) variety and the low flow (ischaemic) priapism. The low flow type is more dangerous, as these patients are susceptible to greater complications and the long term recovery of erectile function is dependent on prompt and urgent intervention. Many of the causes of priapism are medical, including pharmacological agents, and as such, priapism should be considered as a medical and surgical emergency.
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Affiliation(s)
- J Cherian
- Department of Urology, Bradford Royal Infirmary, Bradford, UK
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10
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The modern approach to high-flow priapism. CURRENT SEXUAL HEALTH REPORTS 2006. [DOI: 10.1007/s11930-006-0021-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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11
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Imamoglu A, Bakírtas H, Conkbayír I, Tuygun C, Sarící H. An alternative noninvasive approach for the treatment of high-flow priapism in a child: duplex ultrasound-guided compression. J Pediatr Surg 2006; 41:446-8. [PMID: 16481268 DOI: 10.1016/j.jpedsurg.2005.11.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We are presenting a 5-year-old boy with a traumatic high-flow priapism developed after a straddle injury and successfully treated by compression and simultaneous monitoring with a duplex ultrasound probe. We believe that this may be an alternative method against conventional treatment modalities including conservative follow-up, sympathomimetic drug administration, percutaneous embolization of the fistula, and surgical ligation.
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Affiliation(s)
- Abdurrahim Imamoglu
- Department of Urology, SSK Ankara Education Hospital, 06650 Kízílay, Ankara, Turkey.
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12
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Cakan M, Altu Gcaron U, Aldemir M. Is the combination of superselective transcatheter autologous clot embolization and duplex sonography-guided compression therapy useful treatment option for the patients with high-flow priapism? Int J Impot Res 2005; 18:141-5. [PMID: 16079900 DOI: 10.1038/sj.ijir.3901373] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aim of this study was to report feasibility, benefit and complications of superselective transcatheter autologous clot embolizations and duplex sonography-guided compression therapy in four patients with delayed post-traumatic high-flow priapism. Medical records of four consecutive patients diagnosed with delayed post-traumatic high-flow priapism (arterial priapism) were reviewed. High-flow priapism occurred mean 41.8 (6-92) h after the trauma developed. The patients were presented to hospital mean 8.3 (5-15) days after priapism occurred. The patients were assessed by penile color flow Doppler sonography. After the pathologically increased, arterial flow or arteriocavernosal fistula was seen, combination therapy with superselective transcatheter autologous clot embolizations and duplex sonography-guided compression was performed. If complete detumescence could not be achieved, this therapy was applied in the following day. In patients who had resistance to the second embolization, superselective embolization with microcoil was performed. Follow-up included penile color flow Doppler sonography at the following day, 1 month and 3 months after the procedure. International Impotence Symptoms Score (IIEF) was obtained during the follow-up. The treatment was successful in one, partially successful in one and not successful in two of the four patients. This therapy was reperformed to the latter three patients. After the treatment, high-flow priapism disappeared in one of the three patients and embolization with methalic microcoil was needed to perform to the other two patients. At 1 day after the treatment, color flow Doppler sonography and physical examinations were normal in all four patients. In the 1st and 3rd months of the follow-up, color flow Doppler sonography and the NPT tests were normal in three of the four patients. Slight erectile dysfunction was detected in one patient. Combination of superselective transcatheter autologous clot embolizations and duplex sonography-guided compression therapy may be considered as one of the first-line treatment options in adult patients with delayed post-traumatic high-flow priapism.
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Affiliation(s)
- M Cakan
- 2nd Urology Clinic, SSK Ankara Training Hospital, Ankara, Orta Anadolu, Turkey.
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Abstract
High-flow priapism results from disruption of the intercavernosal artery resulting in an arteriocavernosal fistula and is rarely encountered in the pediatric and adolescent population. Clinically it manifests as a painless, prolonged erection after perineal trauma. Treatment has ranged from expectant management to open surgical exploration with vessel ligation. Internal pudendal arteriogram and superselective embolization with autologous blood clot has emerged as a safe and effective treatment modality in the young male population. Here the authors present 3 patients with high-flow priapism and discuss management of this rare clinical entity.
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Affiliation(s)
- Jeffrey B Marotte
- Department of Urology, Stanford University School of Medicine, Stanford, CA 94305-5118, USA
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Savoca G, Pietropaolo F, Scieri F, Bertolotto M, Mucelli FP, Belgrano E. Sexual function after highly selective embolization of cavernous artery in patients with high flow priapism: long-term followup. J Urol 2004; 172:644-7. [PMID: 15247752 DOI: 10.1097/01.ju.0000132494.44596.33] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE We present 15 cases of high flow priapism treated by selective embolization and evaluate erectile function at long-term followup. MATERIALS AND METHODS Between 1995 and 2001, 15 patients underwent highly selective embolization of the cavernous artery for high flow priapism. Trauma was reported by 12 of the 15 patients, and no etiologic causes were evident in the other 3. The fistula was unilateral in 13 patients and bilateral in 2. All patients underwent embolization during arteriography. Erectile function was determined using the International Index of Erectile Function (IIEF) at followup after an average of 55 months (range 18 to 93). RESULTS Postoperative color Doppler ultrasonography showed no recurrence in 11 patients (73%). Repeat pelvic angiography with selective embolization was required at 1 month postoperatively in 3 patients (20%). In 1 case (7%) 3 consecutive embolizations were not conclusive and a surgical operation was required. The IIEF results showed that sexual function was in the normal range in 80% of patients. Three patients (20%) reported a slight change in the quality of erection. Mean postoperative IIEF score was 26.3 (range 18 to 30). CONCLUSIONS Highly selective embolization of the fistula is an effective and safe treatment option for high flow priapism because it ensures a high level of preservation of pretreatment erectile function.
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Affiliation(s)
- Gianfranco Savoca
- Department of Urology, School of Medicine, University of Trieste, Italy.
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Affiliation(s)
- Sefa Resim
- Department of Urology, KSU Medical School, Kahramanmaras, Turkey.
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Emir L, Tekgül S, Karabulut A, Oskay K, Erol D. Management of post-traumatic arterial priapism in children: presentation of a case and review of the literature. Int Urol Nephrol 2003; 34:237-40. [PMID: 12775103 DOI: 10.1023/a:1023278616343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In this article, a 9-year-old boy with arterial priapism is presented. The patient was managed with the conservative measures including imipramine hydrochloride and a favorable outcome was achieved after 2 months of follow-up. The pathophysiology, diagnostic tools and treatment alternatives are discussed.
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Affiliation(s)
- Levent Emir
- Clinic of Urology, Ankara Teaching and Research Hospital, Ministry of Health, Ankara, Turkey.
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HATZICHRISTOU DIMITRIOS, SALPIGGIDIS GEORGIOS, HATZIMOURATIDIS KONSTANTINOS, APOSTOLIDIS APOSTOLOS, TZORTZIS VASILIOS, BEKOS ATHANASIOS, SARIPOULOS DIMITRIOS. Management Strategy for Arterial Priapism: Therapeutic Dilemmas. J Urol 2002. [DOI: 10.1097/00005392-200211000-00042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hatzichristou D, Salpiggidis G, Hatzimouratidis K, Apostolidis A, Tzortzis V, Bekos A, Saripoulos D. Management strategy for arterial priapism: therapeutic dilemmas. J Urol 2002; 168:2074-7. [PMID: 12394712 DOI: 10.1016/s0022-5347(05)64299-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE We present 7 cases of arterial high flow priapism and propose management algorithms for the condition. MATERIALS AND METHODS We studied 2 children and 5 adults with posttraumatic arterial priapism. Blood gas analysis and color Doppler ultrasonography of the corpora cavernosa confirmed the diagnosis in 4 adults, while 1 patient had already undergone cavernous artery ligation in elsewhere. In the children perineal compression resulted in detumescence, a sign that is proposed to be indicative of the diagnosis of arterial priapism (piesis sign) complementing physical examination. Mechanical compressive force was applied to the perineum of 1 boy, while the other received a watchful waiting program. All adults participated in an observation regimen except 1, who decided to undergo immediate embolization of the internal pudendal artery. RESULTS Perineal compression led to the resolution of priapism in 1 child, while spontaneous resolution was noted in the other. An adult noticed spontaneous penile detumescence 3 to 4 months after trauma, which was attributable to site specific venous leakage and decreased, inflow in the contralateral cavernous artery. The patient underwent venous surgery and is on an intracavernous injection regimen. Successful embolization of the internal pudendal artery was performed immediately in 1 man and in the other 4 months after trauma due to social inconvenience. Adult patient 3 is still on the watchful waiting protocol (42 months), while the one who underwent cavernous artery ligation is receiving treatment for erectile dysfunction. CONCLUSIONS Absent of long-term damaging effects of arterial priapism on erectile tissue combined with the possibility of spontaneous resolution or progressive concomitant hemodynamic abnormalities associated with blunt perineal trauma are suggestive of the introduction of an observation period in the management algorithm of high flow priapism. Such a period may help avoid unnecessary intervention and determine the impact of priapism on patient personal life. Perineal compression may be also added as part of the physical examination as a sign specifically indicative of arterial priapism.
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Affiliation(s)
- Dimitrios Hatzichristou
- Department of Urology, Aristotle University of Thessaloniki and Hippocration General Hospital, Greece
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19
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Wilhelm G, Cohen AM. Traumatic arterial priapism: case report and discussion of a rare urologic injury. Pediatr Emerg Care 2002; 18:E4-7. [PMID: 12187147 DOI: 10.1097/00006565-200208000-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Ginger Wilhelm
- Department of Emergency Medicine, University of Texas Health Science Center, Houston, Texas, USA.
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De Rose AF, Giglio M, De Caro G, Corbu C, Traverso P, Carmignani G. Arterial priapism and cycling: a new worrisome reality? Urology 2001; 58:462. [PMID: 11549504 DOI: 10.1016/s0090-4295(01)01163-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Arterial priapism is a rare condition caused by the traumatic formation of an arteriolacunar fistula. We report 2 cases of arterial priapism after cycling injuries. Both patients sustained a violent perineal trauma against the top tube on the bicycle. In both cases, penile detumescence was obtained by superselective arteriographic embolization of the fistula with gelatin sponge or microcoil. The fistula was monolateral in the first case and bilateral in the second. Cycling should be considered a possible risk factor for arterial priapism as it is for urethritis, prostatitis, hematuria, testicular torsion, scrotal and penile numbness, and erectile dysfunction.
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Affiliation(s)
- A F De Rose
- Department of Urology, San Martino Hospital, University of Genoa, Genova, Italy
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