Priapism: etiology, pathophysiology and management

Horst, Christof van der; Stuebinger, Henrik; Seif, C.; Melchior, D.; Martinez-Portillo, F. J.; Juenemann, Klaus‐Peter

doi:10.1590/s1677-55382003000500002

Cited by 54 publications

(65 citation statements)

References 35 publications

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“…a p= 0.8785, b p=0.6752. Stereological study of the elastic fiber and smooth muscle cell system in the bovine and buffalo penis Changes in the quantity and morphology of collagen and elastic fibers may result of diseases that lead to erectile dysfunction, such as priapism and Peyronie's disease (Brock et al 1997, Van der Horst et al 2003, Tazi 2009, and other disorders, such as preputial prolapse, phimosis, balanitis, fibropapilloma, acropostitis and penile deviation (Rabelo et al 2008). Elastic fibers stabilize the collagen and are characterized by elasticity and extensibility, as one of the properties of elastin is to promote the support and elasticity (Cotta-Pereira et al 1976, Kreis & Vale 1993.…”

Section: Discussionmentioning

confidence: 99%

Stereological study of the elastic fiber and smooth muscle cell system in the bovine and buffalo penis

Ribeiro

Figueiredo

Costa³

et al. 2013

Pesq. Vet. Bras.

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Pesq. Vet. Bras. 33(Supl.1):107-112, dezembro 2013 107 RESUMO.-[Estereologia do sistema elástico e das célu-las musculares lisas no pênis fibroelástico zebuino e bubalino.] O pênis dos zebuinos e bubalinos são classificados como do tipo fibroelástico, sendo grande parte de sua rigidez conferida pelas fibras colágenas e elásticas presentes na matriz extracelular. Embora alguns estudos tenham abordado estes componentes em bovinos europeus, os dados na literatura sobre zebuínos e bubalinos são escassos. Nós avaliamos a espessura da túnica albugínea, a distribuição das células musculares lisas e a densidade volumétrica (Vv) das fibras do sistema elásticona túnica albugínea, no corpo cavernoso e esponjoso do pênis de animais jovens adultos inteiros.Foram utilizados 10 fragmentos de pênis de búfalos da raça Mediterrâneo e 10 fragmentos de pênis de bovinos da raça Red Sindi. Os fragmentos de pênis foram processados de acordo com a técnica histológica de rotina para inclusão em parafina e corados pela Fucsina Resorcina de Weigert, Picro Sirius Red, Tricrômio de Gomori e anticorpo anti α actina. As fibras elásticas foram determinadas em 25 campos aleatórios de cada fragmento, utilizando o sistema teste modelo M42. A Vv das fibras do sistema elástico no pênis do búfalo e bovino foram(média e desvio padrão respectivamente) de 4,07% ±0,88 e 3,36% ±1,21 na túnica albugínea; 17,32% ±2,21 e 13,14% ±1,27 no corpo cavernoso; 26,58% ±4,31 e 31,36% ±3,67 no corpo esponjoso, respectivamente. Houve diferença na Vv das fibras elásticas entre as duas espécies, no corpo cavernoso e no corpo esponjoso. Na espessura da túnica albugínea houve diferença significativa entre o búfalo Mediterrâneo (1,4mm ±0,11) e o bovino Red Sindi (1,76mm ±0,23). Nas duas espécies, as fibras musculares lisas foram encontradas apenas associadas ao endotélio de revestimento dos seios cavernosos. Com base nestes resultados, podemos concluir que existem diferenças na proporção entre os componentes da matriz extracelular nas espécies estudadas, fato que deve ser considerado nos procedimentos clínicos e cirúrgicos veteriná-rios e continua a ser investigado. Samples of ten penises of Mediterranean buffaloes and ten penises of Red Sindhi cattle were used. The thickness of the tunica albuginea (TA), distribution of smooth muscle cells (SMC) and volume density (Vv) of elastic system fibers in TA, corpus cavernosum (CC) and corpus spongiosum (CS) were evaluated. The Vv of elastic system fibers in buffalo and bovine penis was respectively 4.07% ±0.88% and 3.36% ±1.21% in TA; 17.32% ±2.21% and 13.14% ±1.27% (CC), 26.58% ±4.31% and 31.36% ±3.67% (CS). The CC of buffalo presented higher Vv of elastic fibers than bovine, while in the CS the Vv of elastic fibers in buffaloes was smaller than in cattle. The TA thickness showed a significant difference among the species studied. The arrangement of SMC in the bovine penises and in the water buffalo suggests that this pattern is common to animals that have fibroelastic penises.

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Section: Discussionmentioning

confidence: 99%

Stereological study of the elastic fiber and smooth muscle cell system in the bovine and buffalo penis

Ribeiro

Figueiredo

Costa³

et al. 2013

Pesq. Vet. Bras.

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“…Em casos de baixo fluxo, o sangue estará escuro, acidótico (pH < 7), hipoxêmico (pO 2 < 40 mmHg) e hipercárbico (pCO 2 > 70 mmHg). Em casos de alto fluxo, ele será vermelho vivo (arterial), alcalótico (pH < 7), com oxigenação normal (pO 2 > 60 mmHg) e baixo pCO 2 (< 70 mmHg) 18 .…”

Section: Diagnósticounclassified

Priapism in children: review of pathophysiology and treatment

Jesus¹,

Dekermacher²

2009

J Pediatr (Rio J)

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Objective: Priapism may cause serious sequelae concerning the future sex life of the patient, as it can determine impotence, erectile dysfunction or psychogenic sexual aversion. It is a common symptom of sickle cell disease in children and adolescents. There are few good quality evidence manuscripts about the problem in current medical literature. Sources:Literature review on the databases MEDLINE and LILACS covering the period from 1966 to 2008. Summary of the findings:The basis for the treatment of low flow priapism includes treating sickle cell disease and the usage of intracavernous adrenergic agents as necessary. Surgery is indicated in a minority of cases. The treatment of pediatric cases demands dose adjustments, adequate drug choice and sedoanalgesia to cover procedures involving pain or trauma. Conclusions:A new physiopathologic theory concerning sickle cell disease, which questions the traditional vascular blockage mechanisms by deformed red cells and proposes that endothelial inflammatory activation is the main cause of clinical problems, allows to propose new therapeutic maneuvers to solve sickle cell priapism. The absence of good quality evidence to treat sickle cell priapism suggests the necessity to conduct good prospective multicenter protocols to investigate the condition.J Pediatr (Rio J). 2009;85(3):194-200: Priapism, sickle cell disease, children. ResumoObjetivo: O priapismo pode causar sequelas graves em relação à vida sexual futura do paciente, pois pode determinar impotência, disfunção erétil ou aversão sexual psicogênica. É um sintoma comum da doença falciforme em crianças e adolescentes. Há poucos estudos com evidências de qualidade sobre esse problema na literatura médica atual. Fontes dos dados:Revisão da literatura utilizando as bases de dados MEDLINE e LILACS no período de 1966 a 2008. Síntese dos dados:A base para o tratamento de priapismo de baixo fluxo inclui o tratamento da doença falciforme e o uso de agentes adrenérgicos por administração intracavernosa conforme necessário. Indica-se cirurgia em uma minoria de casos. O tratamento de casos pediátricos exige ajuste de doses, escolha adequada de medicamentos e sedoanalgesia para procedimentos envolvendo dor ou trauma. Conclusões:Uma nova teoria fisiopatológica relativa à doença falciforme, que questiona os mecanismos tradicionais de bloqueio vascular por hemácias deformadas e propõe que a ativação inflamatória endotelial é a principal causa de problemas clínicos, permite propor novas manobras terapêuticas para lidar com o priapismo na doença falciforme. A ausência de evidência de qualidade para tratar o priapismo na doença falciforme sugere a necessidade de conduzir bons protocolos prospectivos multicêntricos para investigar essa condição.J Pediatr (Rio J). 2009;85(3):194-200 Artigo submetido em 22.09.08, aceito em 12.11.08.

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“…Three types of priapism have been described: low-flow (ischemic), high-flow (non-ischemic), and recurrent [1,2]. High-flow priapism is a rare condition; it differs from lowflow priapism in that there is a direct arterial connection to the corpus cavernosum, frequently following perineal or penile trauma.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Direct Puncture Embolization with N-butyl-cyanoacrylate for High-flow Priapism

Tokue

Shibuya

Ueno

et al. 2016

Cardiovasc Intervent Radiol

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There are many treatment options in high-flow priapism. Those mentioned most often are watchful waiting, Doppler-guided compression, endovascular highly selective embolization, and surgery. We present a case of high-flow priapism in a 57-year-old man treated by percutaneous direct puncture embolization of a post-traumatic left cavernosal arteriovenous fistula using N-butyl-cyanoacrylate. Erectile function was preserved during a 12-month follow-up. No patients with percutaneous direct puncture embolization for high-flow priapism have been reported previously. Percutaneous direct puncture embolization is a potentially useful and safe method for management of high-flow priapism.

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Priapism: etiology, pathophysiology and management

Cited by 54 publications

References 35 publications

Stereological study of the elastic fiber and smooth muscle cell system in the bovine and buffalo penis

Stereological study of the elastic fiber and smooth muscle cell system in the bovine and buffalo penis

Priapism in children: review of pathophysiology and treatment

Percutaneous Direct Puncture Embolization with N-butyl-cyanoacrylate for High-flow Priapism

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