Malignant priapism secondary to adenocarcinoma of the prostate

Kitley, Charles; Mosier, Andrew; Keylock, Joren; Nguyen, David

doi:10.1136/bcr.07.2009.2135

Cited by 9 publications

(18 citation statements)

References 8 publications

(20 reference statements)

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“…cauda equina, spinal cord injury) [11,12] Haematological Disorders (E.g. Sickle Cell Disease, thalassaemia) [10] Tumours [13] Medications (E.g. vasoactive erectile agents, α-receptor antagonists, anticoagulants) [11,14] Recreational Drugs (E.g.…”

Section: Incidencementioning

confidence: 99%

“…[10] Common causes of priapism are summarised in Table 1. [1,[10][11][12][13][14][15] Diagnosis Diagnosis should be made as soon as possible after presentation; positive outcomes and future erectile function are closely related to the duration of tumescence. Often a diagnosis of priapism is self-evident and can be deduced from a brief history and examination.…”

Section: Incidencementioning

confidence: 99%

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Ischaemic priapism: A clinical review

Ridgley

Raison

Sheikh

et al. 2017

Turkish Journal of Urology

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Objective: Ischaemic priapism is a rare condition characterised by little or no cavernosal blood flow, pain and rigidity of the penis. Immediate intervention is required to restore blood flow, prevent necrosis and erectile dysfunction. This review was conducted to determine the best course of treatment and identify areas in current guidelines to which improvements could be made. PubMed, Ovid, MEDLINE (1946-December 2016 and the Cochrane Library were searched as sources for literature. Key studies in each of the areas of management were identified and analysed. Material and methods:Results: A total of 45 articles were reviewed. The first step in treatment should be aspiration of corporeal blood. Further studies are needed to make firm recommendations as to whether irrigation should follow, as currently literature is inconclusive. If this fails to cause detumescence, sympathomimetics should be injected. The sympathomimetic of choice is phenylephrine as it is effective, specific and causes minimal cardiovascular side effects. It should be injected at a concentration of 100-500 μg/mL, with 1 mL being injected every 3-5 minutes for up to an hour (maximum 1mg in an hour). Surgical shunting is the next step, except in the cases of delayed priapism (48-72 hours duration) where immediate penile prosthesis insertion may be considered more appropriate. Distal shunts should be performed first, followed by proximal ones to minimise damage leading to erectile dysfunction. There exists little evidence recommending one shunting procedure over another. The final intervention is insertion of a penile prosthesis. Literature suggests that an inflatable prosthesis inserted immediately will yield the greatest patient satisfaction. Conclusion:A review of the literature has highlighted areas in which further research needs to be done to make conclusive recommendations, including whether irrigation should accompany aspiration and efficacy of shunting procedures. Further studies are required to ensure that patients receive the treatment most likely to cause detumescence and maintain erectile function.

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Section: Incidencementioning

confidence: 99%

Section: Incidencementioning

confidence: 99%

Ischaemic priapism: A clinical review

Ridgley

Raison

Sheikh

et al. 2017

Turkish Journal of Urology

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“…The average time of presentation sited for penile metastases is between 3 and 4 years after the initial diagnosis of prostate cancer 3 , 4 which further highlights rarity of malignant priapism in this case. MRI offers the most reliable technique in the differentiation of lesions of the phallus and involvement of neighboring pelvic organs.…”

Section: Discussionmentioning

confidence: 70%

Malignant priapism in metastatic prostate cancer: A late event occurring early

Barrett-Campbell

Petkovska

Slovin

2018

Urology Case Reports

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“…The characteristics of the cases are represented in Table 2. 7,9–46 The primary malignancy was of urological origin in 75% of cases, with 58% arising from bladder or prostate.…”

Section: Resultsmentioning

confidence: 99%

Malignant priapism: Review of the report in three decades

Hosny

Nosseir

Pearce

2020

Journal of Clinical Urology

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Introduction: Priapism is one of the few critical male urological emergencies. There are two main types of priapism, low flow/venous and high flow/arterial priapism. Malignant priapism is a rare subtype of low flow priapism usually secondary to pelvic malignancy, but other extra-pelvic primary cancers cannot be completely excluded. Aim: To assess and highlight the poor prognosis of malignant priapism, with a view to directing management towards both symptomatic relief and improving patients’ quality of life. Method: All reports of malignant priapism between 1998 and 2018 were searched and assessed focusing on the primary cancer, duration of complaint, associated symptoms, method of management and prognosis. Conclusion: Malignant priapism is a rare form of ischaemic priapism, resistant to successful therapies utilized in the management of other forms of ischaemic priapism. Urological cancers are the most common primaries implicated with the most commonly associated symptoms being pain and urinary symptoms. In the absence of any evidence based guidelines and reliably successful treatment options, clinicians should aim to employ supportive treatment strategies including adequate analgesia. Level of evidence: level4

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Malignant priapism secondary to adenocarcinoma of the prostate

Cited by 9 publications

References 8 publications

Ischaemic priapism: A clinical review

Ischaemic priapism: A clinical review

Malignant priapism in metastatic prostate cancer: A late event occurring early

Malignant priapism: Review of the report in three decades

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