Medical management of ischemic stuttering priapism: a contemporary review of the literature

Abstract

Priapism is defined as a prolonged and persistent erection of the penis without sexual stimulation. This is a poorly understood disease process with little information on the pathophysiology of this erectile disorder. Complications from this disorder are devastating due to the irreversible erectile damage and resultant erectile dysfunction (ED). Stuttering priapism, though relatively rare, affects a high prevalence of men with sickle-cell disease (SCD) and presents a challenging problem with guidelines for treatment lacking or resulting in permanent ED. The mechanisms involved in the development of priapism in this cohort are poorly characterized; therefore, medical management of priapism represents a therapeutic challenge to urologists. Additional research is warranted, so we can effectively target treatments for these patients with prevention as the goal. This review gives an introduction to stuttering priapism and its clinical significance, specifically with regards to the patient with SCD. Additionally, the proposed mechanisms behind its pathophysiology and a summary of the current and future targets for medical management are discussed.

Etiological factors and management in priapism patients and attitude of emergency physicians

“…It is recommended to manage stutter priapism like priapism (13). Medical agents such as pseudoephedrine, ketoconazole, GnRh agonists and 5-alpha reductase inhibitors were used for priapism attack and for preventing the attack (2,12,14). We applied pseudoephedrine+benzodiazepine+keto-conazole medical treatment for our stutter priapism patients and we were successful in the treatment of four attacks.…”

Priapism is Associated with Sleep Hypoxemia in Sickle Cell Disease

“…14 A retrospective study of 305 males with SCD and priapism demonstrated a bimodal distribution of the age at onset with peaks at 5 to 13 and 21 to 29 years. 7 Erectile dysfunction has been described in patients with priapism, 8,12 as has an increased risk of further SCD complications, 15 including pulmonary hypertension in adulthood. 2,5 Nevertheless, priapism remains one of the least investigated complications of SCD.…”

Idiopathic stuttering priapism treated with salbutamol orally: a case report

“…The goal of the management of RIP is the prevention of future episodes (Hoeh & Levine, 2014). Current medical options include anti-androgens (Dahm et al, 2002), LH-RH agonist (Levine & Guss, 1993), 5-alpha-reductase inhibitors (Rachid-Filho et al, 2009), oestrogen (Serjeant et al, 1985), ketoconazole (KTZ) (Hoeh & Levine, 2014), phosphodiesterase-5 inhibitors (PDE5i) (Burnett et al, 2006), digoxin (Gupta et al, 1998), gabapentin (Perimenis et al, 2004), baclofen (Rourke et al, 2002) and terbutaline (Muneer et al, 2008;Kheirandish et al, 2011;Levey et al, 2012). Herein we report a case of RIP successfully treated with oral salbutamol.…”