Diluted Epinephrine Solution for the Treatment of Priapism

Abstract

We report our experience with 18 consecutive cases of priapism treated with intracorporeal irrigations of dilute epinephrine solution. Of the 18 patients 16 were treated successfully. The 2 failures had priapism 36 hours and 5 days in duration, respectively.

Intrakavernöse Phenylephrininjektion bei pharmakologisch induzierter prolongierter Erektion

“…Phenylephrin ist ein selektiver a 1-Rezeptorenstimulator, der die arterielle Blutzufuhr in den kavernosalen Sinusoiden reduziert, keine Stimulation von b -Rezeptoren verursacht und damit auch bei Arrhythmie, Angina pectoris und Hypertonie einsetzbar ist. Der Wirkungseintritt am a -Rezeptor nach intrakavernö ser Injektion beginnt bereits nach weniger als 1 min und hä lt zwischen 7 und 20 min an [8,13].…”

“…emissariae. Daraus resultiert eine Zunahme der venö sen Drainage mit anschließender Detumeszenz des Gliedes [8].…”

Priapism in Children: Review

“…24 Az olmakla birlikte baş ağrısı, taşikardi, hipertansiyon, baş dönmesi, refleks bradikardi ve subaraknoid kanama görülebilmektedir. 31 Amerikan Üroloji Derneği (AUA), IKE'de alfa-1 reseptörlere selektif olan fenilefrini önermektedir. Erişkinlerde 100-500 µg dozunda önerilse de ço-cuklarda daha düşük konsantrasyonlarda ve düşük hacimlerde kullanılmasına rağmen doz için spesifik bir öneri bulunmamaktadır (Şekil 2).…”

Priapism pathophysiology: clues to prevention

“…Pharmaceutical approaches described to offer benefit include: intracorporal thrombolytic agents, which would support the pathogenic roles of blood stasis and thrombosis, 57,58 oral diethylstilbestrol, which by exerting antiandrogenic effects would imply that androgens permit aberrant penile erection; 35 systemic injections of gonadotropin-releasing hormone analogues, which because they are also anti-androgenic would further hypotheses about the pathogenic role of androgens; 59,60 lidocaine as a penile anesthetic block, which is considered to work by blunting sensory input conveyed in the dorsal nerve of the penis of reflexive erectile pathways; 61 oral and intracorporal alpha-adrenergic agonists, which exert contractile effects on erectile tissue, thus indicating the likely pathogenic role of uncontrolled non-adrenergic factors; 24,60,62,63 intracorporal methylene blue, an antagonist of the nitric oxide/ cyclic guanosine monophosphate/protein kinase G effector mechanism of corporal smooth muscle relaxation, pointing to a possible pathogenic role of this biochemical pathway. 64,65 Basic science investigation Basic research in the field has consisted mainly of identifying and evaluating animal models featuring priapic behavior and molecular studies that suggest possible mechanisms for the disorder.…”

“…After all, these individuals fit a predictable pattern of progression to erectile tissue destruction in which, it would seem, clinical opportunities exist to gain disease control. Presently, current pharmacologic treatment successes support the roles of androgenic suppressive agents, 59,60 adrenergic agonist therapies, 24,60,62,63 and effectors of the nitric oxide-dependent erection regulatory pathway in the penis such as methylene blue. 64,65 As promising as these therapies have been, they still warrant certain considerations such as when they should be administered, whether they can be administered with minimal penile trauma and without causing adverse extra-penile effects, and whether they can be offered with a regimen that does not impair natural erections long term.…”