Recurrent priapism in the setting of cannabis use

Abstract

Priapism (persistent and painful erection of the penis) is a notable urological emergency, with over 90% of those remaining erect for 24 h losing sexual function. Drug-induced priapism is common in the adult population, with intracavernosal injectables for erectile dysfunction topping the list. A variety of illicit drugs associated with priapism have been described; however, we are not aware of any other case reports showing cannabis alone as the inciting factor. Here, we present a case of a healthy 32-year-old African American man with a history of stuttering (recurrent) priapism secondary to mild cannabis substance use without comorbid substance use, licit or illicit.

The Effectiveness of Priapism's Structured Educational Module on Nurses' Knowledge, Attitude, Beliefs, and Patient’s Profile

“…As well as was concordant with Dutta, et al who identified that the mean age of the respondents was 29.8 years ± 13.3 years (29) . This is inconsistent with Montgomery, et al who found that the studied patients with priapism a Mean±SD= 23.6±8.8 years and were not married (31) . Similarly, Menon, and Rahman, reported that mostly of the studied case aged of a 20 year (32) .…”

Penile self-amputation due to cannabis-induced psychosis: a case report

“…However, our patient’s condition did not fulfill priapism diagnostic criteria because the penis was cut off before the erection exceeded 4 hours. Sickle cell disease as a priapism risk factor is a rare disease in our patient population, and his blood investigations did not demonstrate anemia [ 17 ]. Although there are some previous case reports about cannabis use and priapism, the reported patients used cannabis combined with other substances.…”

“…Therefore, cannabinoid use promoting dopaminergic pathway might play a role in penile erection [ 19 ]. Moreover, cannabinoids block the thoracolumbar sympathetic pathway, which could result in the penis being unable to detumescence and increasing the risk of priapism [ 17 , 21 ]. THC interacts with a cannabinoid type 1 (CB1) receptor in the central nervous system (CNS), peripheral nervous system, and vasculature.…”

“…THC interacts with a cannabinoid type 1 (CB1) receptor in the central nervous system (CNS), peripheral nervous system, and vasculature. Consequently, cannabinoids might potentiate vascular effects and lead to penile erection and priapism [ 17 , 19 ]. Although SR 141716A is a CB1 receptor antagonist, it increases the glutamic acid and also activates the oxytocinergic neurons, leading to penile erection in the rat model [ 22 ].…”

“…Recently, a previous case report suggested a relationship between cannabis use alone and priapism. However, the patient smoked cannabis for the previous 6 months and no self-harm or psychosis occurred [ 17 ]. Although priapism is a painful event, self-amputation is rare in a patient with normal judgement.…”