Management of Recurrent Ischemic Priapism 2014: A Complex Condition with Devastating Consequences

Hoeh, Michael P.; Levine, Laurence A.

doi:10.1002/smrj.37

Cited by 10 publications

(5 citation statements)

References 83 publications

(86 reference statements)

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“…The reported visual outcomes were positive with an average of 4 lines increase in vision. Hoeh et al [15] likewise demonstrated inactivation of CNVM lesions with an average of 3.5 injections (range 1–8). However, the follow-up after the last injection was rather brief, thus limiting available data regarding long-term visual improvement or stability.…”

Section: Discussionmentioning

confidence: 98%

“…Bevacizumab has been used alone to treat peripapillary CNVM [14, 15]. Figueroa et al [14] treated 6 eyes with bevacizumab, including 2 after surgery and 1 eye with previous PDT treatment.…”

Section: Discussionmentioning

confidence: 99%

“…These agents are also being utilized to treat various other conditions associated with choroidal neovascularization, including peripapillary CNVM [14, 15]. There is also a rationale for combining various therapies for CNVM associated with subfoveal lesions [16] or peripapillary lesions [17].…”

Section: Introductionmentioning

confidence: 99%

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Bevacizumab (Avastin) and Thermal Laser Combination Therapy for Peripapillary Choroidal Neovascular Membranes

Adrean

Grant

Chaili

2017

Journal of Ophthalmology

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Objective. This is a retrospective interventional case series describing the results of 5 eyes from 5 patients with symptomatic peripapillary choroidal neovascularization (CNVM) receiving initial bevacizumab treatment followed by thermal laser and bevacizumab combination therapy. Methods. Patients received intravitreal bevacizumab injections until the lesions were well-defined. Thermal laser ablation was then administered and followed by an additional bevacizumab injection after one week. Visual outcomes, OCT changes, and rates of recurrence were recorded and analyzed. Results. Median visual outcomes improved from 20/50 to 20/30 (p = 0.0232). Median central macular thickness decreased from 347 μm to 152 μm (p = 0.0253). The mean visual improvement was 3 lines. An average of 3.8 bevacizumab injections per patient were given overall. Patients were followed for an average of 24 months, during which all eyes were absent for recurrence. Conclusion. Symptomatic peripapillary CNVM may be successfully managed with bevacizumab followed by a combination of thermal laser and bevacizumab without the need for frequent retreatment. The area requiring treatment may be better defined using bevacizumab, limiting the ablation of the healthy retina and improving treatment margins. With this treatment regimen, the patients experience improved visual outcomes and have a low rate of recurrence.

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Section: Discussionmentioning

confidence: 98%

“…Bevacizumab has been used alone to treat peripapillary CNVM [14, 15]. Figueroa et al [14] treated 6 eyes with bevacizumab, including 2 after surgery and 1 eye with previous PDT treatment.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Bevacizumab (Avastin) and Thermal Laser Combination Therapy for Peripapillary Choroidal Neovascular Membranes

Adrean

Grant

Chaili

2017

Journal of Ophthalmology

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“…Moreover, the duration of the last nocturnal erection in patients with stuttering priapism often persists for 3 to 4 hours and in one third of all cases ends with ischemic priapism requiring emergency intervention. 6 In contrast, the duration of SRPEs after awakening is often shorter than 1 hour and even shorter than 15 minutes in a large number of patients. Moreover, none of the patients with SRPE needed intervention other than cooling, micturition, walking around, or simply “thinking the erection away.” Although we describe 5 patients who developed painful non–sex-related erections during daytime, we could not diagnose stuttering priapism, because these erections disappeared within 4 hours.…”

Section: Discussionmentioning

confidence: 99%

“…This is remarkable because sleep-related erections depend more on androgen than erections related to sexual activities. 4 , 5 , 6 Other pharmacologic treatment forms were used in only a small number of patients, which makes it impossible to draw any conclusions.…”

Section: Discussionmentioning

confidence: 99%

Sleep-Related Painful Erections—A Case Series of 24 Patients Regarding Diagnostics and Treatment Options

et al. 2017

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BackgroundPatients with sleep-related painful erections (SRPEs) have deep penile pain during nocturnal erection that wakes them up and disturbs their nights of sleep. This rare parasomnia is poorly recognized by general practitioners and by urologists and sexologists.AimTo gain more insight into diagnostics and therapeutic options.MethodsData from a series of 24 consecutive patients who presented with SRPEs at the outpatient clinic from 1996 to 2015 were retrospectively analyzed. Additional questionnaires were completed to complement data and to obtain information about follow-up. Long-term treatment efficacy of baclofen was assessed using the Wilcoxon signed rank test.OutcomesSRPEs were not associated with urologic, surgical, or psychiatric history or with serum testosterone levels. The mean doctors’ delay was 3.5 years. 14 of the 24 patients were treated with baclofen (10–75 mg). In 11 of them, complete remission was observed within a few weeks. 2 of the 3 remaining patients noticed a slight improvement of SPRE symptoms and only 1 patient experienced no effect at all. After an average follow-up of 4.5 years, only 41.6% of patients who had used baclofen were satisfied with their SRPEs. The others (58.4%) were dissatisfied, mostly owing to relapse of symptoms after the discontinuation of baclofen. Other treatment forms were applied sporadically, with strongly varying results.Clinical ImplicationsThis overview of SRPE contributes to a better clinical understanding and recognition of the phenomenon and provides new, more constructed advice about therapeutic implications, especially concerning the use of baclofen.Strengths and LimitationsThis study provides a systematic overview of a relatively large series of patients with SRPE, which provides substantiated treatment advice. However, treatment efficacy was based mainly on the patients’ subjective perception and it was not possible to compare the results of baclofen with other forms of pharmacologic treatment, because these alternative drugs were applied only sporadically. Nevertheless, this study is directional for future research.ConclusionsThis study confirmed a long doctors’ delay in patients with SRPE. There was no association between SRPEs and comorbidity and total serum testosterone levels. Treatment with baclofen proved successful and safe in the short term. Long-term feasibility needs further investigation.Vreugdenhil S, Weidenaar AC, de Jong IJ, van Driel MF. Sleep-Related Painful Erections—A Case Series of 24 Patients Regarding Diagnostics and Treatment Options. Sex Med 2017;5:e237–e243.

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Priapism in children: an experience of the modified Winter procedure

et al. 2023

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Management of Recurrent Ischemic Priapism 2014: A Complex Condition with Devastating Consequences

Cited by 10 publications

References 83 publications

Bevacizumab (Avastin) and Thermal Laser Combination Therapy for Peripapillary Choroidal Neovascular Membranes

Bevacizumab (Avastin) and Thermal Laser Combination Therapy for Peripapillary Choroidal Neovascular Membranes

Sleep-Related Painful Erections—A Case Series of 24 Patients Regarding Diagnostics and Treatment Options

Priapism in children: an experience of the modified Winter procedure

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