Priapism

Bivalacqua, Trinity J.; Levey, Helen R.; Burnett, Arthur L.

doi:10.1007/978-1-60761-916-1_17

Cited by 2 publications

(3 citation statements)

References 77 publications

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“…It commences with a review of surgical procedures used emergently to address the acute ischemic effects of the condition and then proceeds with a review of surgical procedures used to manage its non‐acute pathologic sequelae. The presentation herein briefly conveys the basic principles, technical pearls, and clinical outcomes of surgical procedures used for ischemic priapism; operative and perioperative details of these procedures are presented in surgical atlases and other sources elsewhere [1–4]. A summary section features a suggested practical framework for applying surgical interventions for this condition.…”

Section: Introductionmentioning

confidence: 99%

Surgical Management of Ischemic Priapism

Burnett

2012

The Journal of Sexual Medicine

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Introduction Surgery is a mainstay in the management of ischemic priapism. The surgical armamentarium for this condition has recently been expanded with the introduction of several innovative procedures. Aim To review surgical procedures offered in the treatment of ischemic priapism and present a rational framework for their use. Methods Medline searches through July 2010 were conducted using the terms priapism, surgery, shunt, and prosthesis. Main Outcome Measure Expert opinion was based on review of the medical literature related to this subject matter. Results A host of surgical procedures exist to address the genital complications of both acute presentations of ischemic priapism and its non-acute pathologic sequelae, which include penile deformities and erectile dysfunction. For the former, the intervention is used principally in an emergent context with the intention to relieve the acute pathologic effects of the condition and preserve erectile function. For the latter, the intervention is aimed generally toward restoring anatomic normalcy and the functional ability to perform sexual intercourse. A rational framework for surgical management, based on the circumstances of the clinical presentation, is described. Conclusions The surgical management for ischemic priapism has evolved with the application of a host of surgical procedures. These procedures address acute and non-acute genital complications of the condition and are intended to retain or restore sexual ability effectively and safely. They can be applied using a rational clinical management framework.

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Section: Introductionmentioning

confidence: 99%

Surgical Management of Ischemic Priapism

Burnett

2012

The Journal of Sexual Medicine

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“…47,48 The current literature neglects to categorize this type of priapism as ischemic or non-ischemic, so additional studies are needed to assess the congruence or lack thereof between recurrent reflexogenic erections and ischemic stuttering episodes. 4,32 In clinical practice, baclofen is not used to treat stuttering priapism but often used in patients having prolonged erections from neurological disease or injury. These types of patients include those presenting with spinal cord injury, neurogenic or distributive shock, degenerative spinal canal stenosis and spondylolisthesis.…”

Section: Hormonal Therapymentioning

confidence: 99%

“…The primary goal of medical therapy for ischemic or stuttering priapism is to relieve the pain and decompress the corporal bodies, thus reducing ischemia and the risk of tissue necrosis and injury. 2,4,15,32 Some men initiated on systemic therapies for stuttering ischemic priapism may not see therapeutic effects immediately and may require intracavernous self-injections at home with sympathomimetic agents such as phenylephrine on an interim basis until ischemic priapism has been alleviated. 32,65,67 Sympathomimetic agents are applied because of their contractile effects which may facilitate detumescence.…”

Section: Intracavernosal Injectionsmentioning

confidence: 99%

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

Levey¹,

Kutlu²,

Bivalacqua³

2011

Asian J Androl

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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.

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Priapism

Cited by 2 publications

References 77 publications

Surgical Management of Ischemic Priapism

Surgical Management of Ischemic Priapism

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

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