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Management of Priapism

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Contemporary Treatment of Erectile Dysfunction

Part of the book series: Contemporary Endocrinology ((COE))

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Abstract

Priapism is a pathological condition characterized by prolonged erection and is a potential urologic emergency. This chapter outlines the management approach to evaluating, diagnosing, and treating priapism. Key components of the evaluation include expeditious and correct classification of priapism and implementation of appropriate therapies in a timely fashion. If ischemic priapism is the etiology, then stepwise therapeutic maneuvers should be implemented to correct the compartment syndrome, reestablish blood flow, and relieve pain. Medical and surgical management options are reviewed.

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References

  1. Burnett AL, Bivalacqua TJ. Priapism: current principles and practice. Urol Clin North Am. 2007;34(4):631–42. viii.

    Article  PubMed  Google Scholar 

  2. Montague DK, et al. American Urological Association guideline on the management of priapism. J Urol. 2003;170(4 Pt 1):1318–24.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  PubMed Central  Google Scholar 

  4. Andersson KE, Wagner G. Physiology of penile erection. Physiol Rev. 1995;75(1):191–236.

    CAS  PubMed  Google Scholar 

  5. Andersson KE. Pharmacology of penile erection. Pharmacol Rev. 2001;53(3):417–50.

    CAS  PubMed  Google Scholar 

  6. Bivalacqua TJ, et al. New insights into the pathophysiology of sickle cell disease-associated priapism. J Sex Med. 2012;9(1):79–87.

    Article  CAS  PubMed  Google Scholar 

  7. Bivalacqua TJ, Burnett AL. Priapism: new concepts in the pathophysiology and new treatment strategies. Curr Urol Rep. 2006;7(6):497–502.

    Article  PubMed  Google Scholar 

  8. Anele UA, Morrison BF, Burnett AL. Molecular pathophysiology of priapism: emerging targets. Curr Drug Targets. 2015;16(5):474–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Corbin JD, Francis SH. Cyclic GMP phosphodiesterase-5: target of sildenafil. J Biol Chem. 1999;274(20):13729–32.

    Article  CAS  PubMed  Google Scholar 

  10. Broderick GA. Priapism and sickle-cell anemia: diagnosis and nonsurgical therapy. J Sex Med. 2012;9(1):88–103.

    Article  CAS  PubMed  Google Scholar 

  11. Eland IA, et al. Incidence of priapism in the general population. Urology. 2001;57(5):970–2.

    Article  CAS  PubMed  Google Scholar 

  12. Salonia A, et al. European Association of Urology guidelines on priapism. Eur Urol. 2014;65(2):480–9.

    Article  PubMed  Google Scholar 

  13. Burnett AL, Bivalacqua TJ. Glucose-6-phosphate dehydrogenase deficiency: an etiology for idiopathic priapism? J Sex Med. 2008;5(1):237–40.

    Article  CAS  PubMed  Google Scholar 

  14. Elliott L, et al. Genetic polymorphisms associated with priapism in sickle cell disease. Br J Haematol. 2007;137(3):262–7.

    Article  CAS  PubMed  Google Scholar 

  15. Spycher MA, Hauri D. The ultrastructure of the erectile tissue in priapism. J Urol. 1986;135(1):142–7.

    CAS  PubMed  Google Scholar 

  16. Kovac JR, et al. A pathophysiology-based approach to the management of early priapism. Asian J Androl. 2013;15(1):20–6.

    Article  PubMed  Google Scholar 

  17. Addis G, et al. The physical, social and psychological impact of priapism on adult males with sickle cell disorder. Chronic Illn. 2007;3(2):145–54.

    Article  PubMed  Google Scholar 

  18. Morrison BF, Burnett AL. Priapism in hematological and coagulative disorders: an update. Nat Rev Urol. 2011;8(4):223–30.

    Article  CAS  PubMed  Google Scholar 

  19. Morrison BF, Burnett AL. Stuttering priapism: insights into pathogenesis and management. Curr Urol Rep. 2012;13(4):268–76.

    Article  PubMed  Google Scholar 

  20. Emond AM, et al. Priapism and impotence in homozygous sickle cell disease. Arch Intern Med. 1980;140(11):1434–7.

    Article  CAS  PubMed  Google Scholar 

  21. Burnett AL, Sharlip ID. Standard operating procedures for priapism. J Sex Med. 2013;10(1):180–94.

    Article  PubMed  Google Scholar 

  22. Yuan J, et al. Insights of priapism mechanism and rationale treatment for recurrent priapism. Asian J Androl. 2008;10(1):88–101.

    Article  CAS  PubMed  Google Scholar 

  23. Melman A, Serels S. Priapism. Int J Impot Res. 2000;12 Suppl 4:S133–9.

    Article  PubMed  Google Scholar 

  24. Kato GJ. Priapism in sickle-cell disease: a hematologist's perspective. J Sex Med. 2012;9(1):70–8.

    Article  CAS  PubMed  Google Scholar 

  25. LeRoy TJ, Broderick GA. Doppler blood flow analysis of erectile function: who, when, and how. Urol Clin North Am. 2011;38(2):147–54.

    Article  PubMed  Google Scholar 

  26. Adeyoju AB, et al. Priapism in sickle-cell disease; incidence, risk factors and complications – an international multicentre study. BJU Int. 2002;90(9):898–902.

    Article  CAS  PubMed  Google Scholar 

  27. Muneer A, et al. Investigating the effects of high-dose phenylephrine in the management of prolonged ischaemic priapism. J Sex Med. 2008;5(9):2152–9.

    Article  CAS  PubMed  Google Scholar 

  28. Munarriz R, et al. Management of ischemic priapism with high-dose intracavernosal phenylephrine: from bench to bedside. J Sex Med. 2006;3(5):918–22.

    PubMed  Google Scholar 

  29. Bodne DR, et al. The application of intracavernous injection of vasoactive medications for erection in men with spinal cord injury. J Urol. 1987;138(2):310–1.

    Google Scholar 

  30. Lee M, Cannon B, Sharifi R. Chart for preparation of dilutions of alpha-adrenergic agonists for intracavernous use in treatment of priapism. J Urol. 1995;153(4):1182–3.

    Article  CAS  PubMed  Google Scholar 

  31. Burnett AL. Surgical management of ischemic priapism. J Sex Med. 2012;9(1):114–20.

    Article  PubMed  Google Scholar 

  32. Brant WO, et al. T-Shaped shunt and intracavernous tunneling for prolonged ischemic priapism. J Urol. 2009;181(4):1699–705.

    Article  PubMed  Google Scholar 

  33. Burnett AL, Pierorazio PM. Corporal “snake” maneuver: corporoglanular shunt surgical modification for ischemic priapism. J Sex Med. 2009;6(4):1171–6.

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  36. Segal RL, et al. Corporal Burnett “Snake” surgical maneuver for the treatment of ischemic priapism: long-term followup. J Urol. 2013;189(3):1025–9.

    Article  PubMed  Google Scholar 

  37. Lue TF, Pescatori ES. Distal cavernosum-glans shunts for ischemic priapism. J Sex Med. 2006;3(4):749–52.

    Article  PubMed  Google Scholar 

  38. Quackels R. Treatment of a case of priapism by cavernospongious anastomosis. Acta Urol Belg. 1964;32:5–13.

    CAS  PubMed  Google Scholar 

  39. Ralph DJ, et al. The immediate insertion of a penile prosthesis for acute ischaemic priapism. Eur Urol. 2009;56(6):1033–8.

    Article  PubMed  Google Scholar 

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Correspondence to Brian V. Le MD, MA .

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Le, B.V., Burnett, A.L. (2016). Management of Priapism. In: Köhler, T., McVary, K. (eds) Contemporary Treatment of Erectile Dysfunction. Contemporary Endocrinology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-31587-4_24

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  • DOI: https://doi.org/10.1007/978-3-319-31587-4_24

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  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-31585-0

  • Online ISBN: 978-3-319-31587-4

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