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Our experience in the treatment of priapism.

Vorobets D, Banyra O, Stroy A, Shulyak A - Cent European J Urol (2011)

Bottom Line: Its etiology includes the impaired mechanism of detumescence caused by the abundant release of neurotransmitters, venules obstruction, impairment of the intrinsic mechanism of detumescence, or prolonged relaxation of the intracavernous smooth muscles.The obtained results allow recommendation of prostaglandin E1 as a medication of choice among the vasoactive substances for intracavernous use due to high efficacy and low side effects.Unilateral transcaputal puncture of the cavernous body (shunting after Winter) in our patients with ischemic priapism allowed to achieve detumescence in 100% of cases without subsequent recurrence and to restore erectile function in 30% of patients.

View Article: PubMed Central - PubMed

Affiliation: Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.

ABSTRACT
Priapism is a persistent erection without sexual stimulation that cannot be relieved by orgasm. Its etiology includes the impaired mechanism of detumescence caused by the abundant release of neurotransmitters, venules obstruction, impairment of the intrinsic mechanism of detumescence, or prolonged relaxation of the intracavernous smooth muscles. Treatment of priapism is conservative, pharmacological, or surgical. Efficient treatment options include the intracavernous vasoconstrictor injections or surgical shunting. Alternative treatment options include the intracavernous methylene blue injections or selective penile arterial embolization. Between 2001 and 2009, we treated 10 patients with priapism at our clinic. According to our data, priapism as a complication after intracavernous administration of prostaglandin E1 occurs in 2.7% of patients, after additional administration of prostaglandin E1 and phentolamine - in 5.0% patients, after administration of papaverine - in 8.3% patients. The obtained results allow recommendation of prostaglandin E1 as a medication of choice among the vasoactive substances for intracavernous use due to high efficacy and low side effects. Initially all cases of priapism must be treated pharmaceutically, but can be converted to surgery as needed. Unilateral transcaputal puncture of the cavernous body (shunting after Winter) in our patients with ischemic priapism allowed to achieve detumescence in 100% of cases without subsequent recurrence and to restore erectile function in 30% of patients.

No MeSH data available.


Related in: MedlinePlus

One-sided transcaputal puncture after Winter.
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Figure 0001: One-sided transcaputal puncture after Winter.

Mentions: For the treatment of priapism initially we used intracavernous injections of E-adrenoreceptor agonists, but such therapy was ineffective. Afterwards all of 10 patients with verified priapism were injected by ketamine hydrochloride 1 mg/kg body mass IV in the operating room, and also peridural anesthesia was performed 20-30 min later, which did not produce detumescence too. After that one-sided transcaputal punctures after Winter were performed (Fig. 1) in all patients, using a 16G needle (single-use IV catheter with an obturator was used) with heparin irrigation 5000-15000 IU during 30-45 minutes.


Our experience in the treatment of priapism.

Vorobets D, Banyra O, Stroy A, Shulyak A - Cent European J Urol (2011)

One-sided transcaputal puncture after Winter.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921718&req=5

Figure 0001: One-sided transcaputal puncture after Winter.
Mentions: For the treatment of priapism initially we used intracavernous injections of E-adrenoreceptor agonists, but such therapy was ineffective. Afterwards all of 10 patients with verified priapism were injected by ketamine hydrochloride 1 mg/kg body mass IV in the operating room, and also peridural anesthesia was performed 20-30 min later, which did not produce detumescence too. After that one-sided transcaputal punctures after Winter were performed (Fig. 1) in all patients, using a 16G needle (single-use IV catheter with an obturator was used) with heparin irrigation 5000-15000 IU during 30-45 minutes.

Bottom Line: Its etiology includes the impaired mechanism of detumescence caused by the abundant release of neurotransmitters, venules obstruction, impairment of the intrinsic mechanism of detumescence, or prolonged relaxation of the intracavernous smooth muscles.The obtained results allow recommendation of prostaglandin E1 as a medication of choice among the vasoactive substances for intracavernous use due to high efficacy and low side effects.Unilateral transcaputal puncture of the cavernous body (shunting after Winter) in our patients with ischemic priapism allowed to achieve detumescence in 100% of cases without subsequent recurrence and to restore erectile function in 30% of patients.

View Article: PubMed Central - PubMed

Affiliation: Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.

ABSTRACT
Priapism is a persistent erection without sexual stimulation that cannot be relieved by orgasm. Its etiology includes the impaired mechanism of detumescence caused by the abundant release of neurotransmitters, venules obstruction, impairment of the intrinsic mechanism of detumescence, or prolonged relaxation of the intracavernous smooth muscles. Treatment of priapism is conservative, pharmacological, or surgical. Efficient treatment options include the intracavernous vasoconstrictor injections or surgical shunting. Alternative treatment options include the intracavernous methylene blue injections or selective penile arterial embolization. Between 2001 and 2009, we treated 10 patients with priapism at our clinic. According to our data, priapism as a complication after intracavernous administration of prostaglandin E1 occurs in 2.7% of patients, after additional administration of prostaglandin E1 and phentolamine - in 5.0% patients, after administration of papaverine - in 8.3% patients. The obtained results allow recommendation of prostaglandin E1 as a medication of choice among the vasoactive substances for intracavernous use due to high efficacy and low side effects. Initially all cases of priapism must be treated pharmaceutically, but can be converted to surgery as needed. Unilateral transcaputal puncture of the cavernous body (shunting after Winter) in our patients with ischemic priapism allowed to achieve detumescence in 100% of cases without subsequent recurrence and to restore erectile function in 30% of patients.

No MeSH data available.


Related in: MedlinePlus