Postoperative drug-induced priapism

Corten, B.J.G.A.; Aarts, Frits; Harms, Ansgar S.; Vogelaar, Jeroen

doi:10.1136/bcr-2016-218060

Cited by 8 publications

(7 citation statements)

References 24 publications

(20 reference statements)

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“…These factors are associated with a prothrombotic state, which could be related to the obstruction of the small emissary veins of the subtunical space [ 11 ]. In our patient, the clinical presentation and penile doppler findings allow the diagnosis of ischemic priapism to be made, and although the presentation of the condition is related to the causal factors of a prothrombotic state, given by the elevation of dimero D, leukocytosis, elevation of CRP and LDH, as well as a condition of nonmodulated inflammation that could argue the cause of priapism, we found a distracting factor and it is the infusion of propofol 24 h before the onset of erection, described in different case reports as the cause of presentation of ischemic priapism, in anesthetic inductions with parenteral or epidural use, by blocking the sympathetic system and influencing smooth muscle relaxation [ 12 , 13 ]. Although he was on prophylactic anticoagulation, a phenomenon of resistance to heparins has been described in patients with SARS-Cov-2, associated with elevated levels of Factor VIII, fibrinogen, and D dimer [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Veno-Occlusive Priapism in COVID-19 Disease

Perez²,

Vasquez

et al. 2021

Urol Int

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Infection by COVID-19, being a respiratory disease caused by SARS-CoV-2, can predispose to arterial and venous thrombotic disease, in response to excessive inflammation, platelet activation, endothelial dysfunction, and venous stasis. During the COVID-19 pandemic period, the technological and resource availability for the care of these patients with thrombotic disease is critical, marking a factor of morbidity and poor prognosis in these cases. We describe a case of priapism in a patient with COVID-19, during the course of systemic inflammatory response syndrome and respiratory distress syndrome with a procoagulant state, seeking to relate the pathophysiological factors of ischemic priapism in patients with infection with SARS-Cov-2

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Section: Discussionmentioning

confidence: 99%

Veno-Occlusive Priapism in COVID-19 Disease

Perez²,

Vasquez

et al. 2021

Urol Int

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“…Unoma Okoli, MD 1 Harpreet Singh, MD 2 Chinmay Jani, MD 1 Rose Franco, MD 2 Mark Barash, MD 2 Housam E. Alhariri, MD 1 mbarash@mcw.edu 1 Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA…”

Section: Propofol-associated Priapismmentioning

confidence: 99%

“…The mainstay of treatment is anticoagulation, which has been shown to be effective and safe in this population. 1,2 However, the literature still lacks high-quality evidence that compares the efficacy of different anticoagulants for this clinical condition. The aim of this systematic review and network meta-analysis is to compare anticoagulant medications in achieving portal vein recanalization in cirrhotic patients with nonmalignant PVT.…”

Section: Propofol-associated Priapismmentioning

confidence: 99%

Propofol-Associated Priapism

Okoli

Singh

Jani

et al. 2022

American Journal of Therapeutics

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inhaled treprostinil solution hemodynamic studies showed that duration and degree of pulmonary vascular resistance reduction were dose-dependent 7,8 and a recent real-world analysis that used specialty pharmacy data of patients receiving inhaled treprostinil, showed higher survival rates and longer time to transition to parenteral therapy in patients who were receiving higher inhaled treprostinil doses. 9

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“…8 The mechanism of propofol-associated priapism is not well understood but thought that it might result from an autonomic system imbalance, leading to an increase in parasympathetic activity. 6 Also, propofol has been shown to affect nitric oxide-mediated smooth muscle relaxation. 7 Propofol-associated priapism is generally categorized into 2 states based on the penile venous blood flow.…”

Section: Discussionmentioning

confidence: 99%

“…We present a case of priapism that occurred in a pediatric patient who was on propofol for sedation in our pediatric intensive care unit (PICU), which was the youngest patient having this rare side effect among a handful of reported cases. 4-7…”

Section: Introductionmentioning

confidence: 99%

Propofol-Associated Priapism in a Prepubescent Pediatric Patient

Savoie

Rajanna

Khandhar

2019

Global Pediatric Health

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Introduction. Propofol is a commonly used sedative medication for procedural sedation with a limited side effect profile. Although well tolerated with minimal adverse reactions, uncommon side effects have been reported. Methods. Case report of priapism in a 9-year-old male following the use of propofol for sedation in the pediatric intensive care unit (PICU) setting. The patient was admitted to the PICU for postoperative management following laryngotracheal reconstruction. On postoperative day 2, our patient was initiated on continuous infusion of propofol and he developed priapism. Propofol was then immediately discontinued, and the priapism quickly resolved without any medical or surgical interventions. Results. Priapism is a low-flow state and is considered a urological emergency requiring prompt recognition, withdrawal of suspected offending agents, and possible need for urologic consultation to alleviate complications. Although rare, priapism with propofol has been reported but never in a prepubescent male. The mechanism of propofol-associated priapism is not well understood, but it is thought that it may result from an autonomic system imbalance, leading to an increase in parasympathetic activity. In addition, propofol has been shown to affect nitric oxide–mediated smooth muscle relaxation. In our patient, we suspected propofol to be contributing factor to his priapism based on the temporal relationship between the initiation of the medication and symptoms and resolution of symptoms after propofol discontinuation. Discussion. Given the expansive use of propofol in pediatrics for sedation and anesthesia, pediatric clinicians should be cognizant of this rare adverse effect in pediatric patients with potentially disastrous complications.

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Postoperative drug-induced priapism

Cited by 8 publications

References 24 publications

Veno-Occlusive Priapism in COVID-19 Disease

Veno-Occlusive Priapism in COVID-19 Disease

Propofol-Associated Priapism

Propofol-Associated Priapism in a Prepubescent Pediatric Patient

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