DOI: http://dx.doi.org/10.18203/2349-3933.ijam20175167

Priapism: what to do?

Mehmet Giray Sönmez, Abdülkadir Kandemir, Mehmet Balasar

Abstract


Priapism is a painful erection condition of penis or clitoris lasting more than four hours without sexual desire. Glans and corpus spongiosum do not participate in this period. Although the incidence is not common in males, it can also be seen in females very rarely. Priapism has three types. These are classifying as; Ischemic (low-flow) priapism, Non-ischemic (high-flow) priapism, Recurrent (stuttering) priapism. Priapism is an urgent urological disease which should be managed well since it may cause severe penile function disorder. Our aim in this article is presenting appropriate management of priapism in the light of current literature. We hope that the studies to be done in the future would be helpful to reveal priapism molecular mechanisms and develop our ability of care for the patients in this condition.


Keywords


Pain, Priapism, Priapism Treatment, Penile erection, Urological emergency

Full Text:

PDF

References


Papadopoulos I, Kelâmi A. Priapus and priapism. From mythology to medicine. Urol. 1988;32(4):385-6.

Pryor J, Akkus E, Alter G, Jordan G, Lebret T, Levine L et al. Priapism. J Sex Med. 2004 ;1(1):116-20.

Shigehara K, Namiki M. Clinical Management of Priapism: A Review. World J Mens Health. 2016;34(1):1-8.

Salonia A, Eardley I, Giuliano F, Hatzichristou D, Moncada I, Vardi Y, et al. European Association of Urology guidelines on priapism. Eur Urol. 2014;65:480-9.

Cherian J, Rao AR, Thwaini A, Kapasi F, Shergill IS, Samman R. Medical and surgical management of priapism. Postgrad Med J. 2006;82(964):89-94.

Song PH, Moon KH. Priapism: current updates in clinical management. Korean J Urol. 2013;54(12):816-23.

Broderick GA, Kadioglu A, Bivalacqua TJ, Ghanem H, Nehra A, Shamloul R. Priapism: pathogenesis, epidemiology, and management. J Sex Med. 2010;7(1 Pt 2):476-500

Kulmala RV, Lehtonen TA, Tammela TL. Priapism, its incidence and seasonal distrubution in Finland. Scand J Urol Nephrol. 1995;29(1):93-6.

McMahon CG. High flow priapism due to an arterial-la-cunar fistula complicating initial veno-occlusive pria-pism. Int J Impot Res. 2002;14(3):195-6.

Witt MA, Goldstein I, Saenz deTejada I, Greenfield A, Krane R. Traumatic laceration of intrakavernozal ar-teries: The pathophysiology of nonischemic, high flow, arterial priapism. J Urol. 1990;143(1):129-32.

Rogers ZR. Priapism in sickle cell disease. Hematol Oncol Clin North Am. 2005;19(5):917-28.

Montague DK, Jarow J, Broderick GA, Dmochowski RR, Heaton JP, Lue TF, et al. American Urological Association Guideline on the management of priapism. J Urol. 2003;170(4 Pt 1):1318-24.

Levey HR, Kutlu O, Bivalacqua TJ. Medical management of ischemic stuttering priapism: a contemporary review of the literature. Asian J Androl. 2012;14(1):156-63.

Powell BL, Craig JB, Muss HB. Secondary malignancies of the penis and epididiymis: A case report and the review of the literature. J Clin Oncol. 1985;3(1):110-6.

Gordon SA, Stage KH, Tansey KE, Lotan Y. Conservative management of priapism in acute spinal cord injury. Urol. 2005;65(6):1195-7.

Baba H, Maezawa Y, Furusawa N, Furusawa N, Kawahara N, Tomita K. Lumbar spinal stenosis causing intermittant priapism. Paraplegia. 1995;33(6):338-45.

Habous M, Elkhouly M, Abdelwahab O, Farag M, Madbouly K, Altuwaijri T, et al. Noninvasive treatments for iatrogenic priapism: Do they really work? A prospective multicenter study. Urol Ann. 2016;8(2):193-6.

Lowe FC, Jarow JP. Placebo controlled study of oral terbutaline and pseudoephedrine in management of prostaglandin E1 induced prolonged erections. Urol. 1993;42:51-3.

Burnett AL, Bivalacqua TJ. Priapism: new concepts in medical and surgical management. Urol Clin North Am. 2011;38(2):185-94.

Kulmala RV, Tamella TL. Effects of priapism lasting 24 hours or longer caused by intracavernosal injection of vasoactive drugs. Int J Impot Res. 1995;7(2):131-6.

Huang YC, Harraz AM, Shindel AW, Lue TF. Evaluation and management of priapism: 2009 update. Nat Rev Urol. 2009;6(5):262-71.

Rutchik S, Sorbera T, Rayford RW, Sullivan J. Successful treatment of recalcitrant priapism using intercorporeal injection of tissue plasminogen activator. J Urol. 2001;166(2):628.

Ebbehøj J. A new operation for priapism. Scand J Plast Reconstr Surg. 1974;8(3):241-2.

Winter CC. Cure of idiopathic priapism: new procedure for creating fistula between glans penis and corpora cavernosa. Urol. 1976;8(4):389-91.

Lian W, Lv J, Cui W. Al-Ghorab Shunt plus intracavernous tunneling for prolonged ischemic priapism. J Androl. 2010;31(5):466-71.

Burnett AL, Pierorazio PM Corporal ‘‘snake’’ maneuver: corporaglanular shunt surgical modification for ischemic priapism J Sex Med. 2009;6(4):1171-6.

Kilinc M. Temporary cavernosal-cephalic vein shunt in low-flow priapism treatment. Eur Urol. 2009;56(3):559-62.

Quackels R. Treatment of a case of priapism by cavernospongious anastomosis [in French]. Acta Urol Belg. 1964;32(1):5-13.

Grayhack JT, McCullough W, O’Coner VJ Jr, Trippel O. Venous bypass to control priapism. Invest Urol. 1964;1(1):509-13.

De Stefani S, Savoca G, Ciampalini S, Stener S, Gattuccio I, Belgrano. E. Urethrocutaneous fistula as a severe complication of treatment for priapism. BJU Int. 2001;88(6):642-3.

Kandel GL, Bender LI, Grove JS. Pulmonary embolism: a complication of corpus-saphenous shunt for priapism. J Urol. 1968;99(2):196-7.

Berger R, Billups K, Brock G, Broderick GA, Dhabu-wala CB, Goldstein I, et al. Report of the AFUD Thought Leader Panel for evaluation and treatment of priapism. Int J Impot Res. 2001;13(5):39-43.

Rees RW, Kalsi J, Minhas S, Peters J, Kell P, Ralph DJ. The management of low-flow priapism with the im-mediate insertion of a penile prosthesis. BJU Int. 2002;90(9):893-7.

Kumar P, Minhas S, Brown C, Muneer A, et al. Ischemic priapism: Acute implant insertion and long-term follow-up. AUA annual meeting, abstrn no: 2005.1271.

Monga M, Broderick GA, Hellstrom WA. Priapism in sickle cell disease: The case for early implantation of the penile prosthesis. Eur Urol. 1996;30(1):54-9.

Ilkay AK, Levine LA. Conservative management of high-flow priapism. Urol. 1995;46(3):419-24.

Ficarra V, Beltrami P, Sarti A, Rubilotta E, Righetti R, Malossini G. High flow priapism due to a bilateral arteriosinusoidal fistula. Scand J Urol Nephrol. 2001;35(5):418-9.

Kadıoğlu A, Şanlı Ö, Ersay A, Çakan M, Taşkapu HH, Akman T. Practical Management of Patients with Priapism EAU-EBU update series 4. 2006;4(4):150-60.

Fowler JE, Koshy M, Strub M, Chinn SK. Priapism associated with sickle cell hemoglobinopathies: Prevalence, na-tural history and sequelae. J Urol. 1991;145(1):65-8.

Burnett AL, Bivalacqua TJ, Champion HC, Musicki BJ. Feasibility of the Use of Phosphodiesterase Type 5 Inhibitors in a Pharmacologic Prevention Program for Recurrent Priapism. J Sex Med. 2006;3(6):1077-84.

Rachid-Filho D, Cavalcanti AG, Favorito LA, Costa WS, Sampaio FJ. Treatment of recurrent priapism in sickle cell anemia with finasteride: a new approach. Urol. 2009;74(5):1054-7.

Perimenis P, Athanasopoulos A, Papathanasopoulos P, Barbalias G. Gabapentin in the management of the recurrent, refractory, idiopathic priapism. Int J Impot Res. 2004;16(1):84-5.

Teloken C, Ribeiro EP, Chammas M, Teloken P, Souto CAV. Intrakavernozal etilefrine self-injection therapy for recurrent priapism: one decade of follow-up. Urol. 2005;65(5):1002.