Review of Priapism Litigation in the United States

Matz, Ariana; Ambinder, David; Spencer, Evan; Phillips, John L.; Wong, Nathan

doi:10.1016/j.urology.2021.05.001

Cited by 4 publications

(5 citation statements)

References 6 publications

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“…Based on these premises, it appears that, among the high-risk list of drugs here analysed, trazodone generated indeed the strongest SDR, whilst olanzapine and tadalafil seemed somewhat more prone to cause priapism vs. the other drugs of the database (except for trazodone). The propensity of trazodone to elicit priapism is already well documented in the literature [19][20][21]. Although a number of medications identified in this list may be prescribed by sexual medicine specialists, most of these drugs are typically prescribed by psychiatrists and primary care doctors.…”

Section: Discussionmentioning

confidence: 99%

Medications mostly associated with priapism events: assessment of the 2015–2020 Food and Drug Administration (FDA) pharmacovigilance database entries

et al. 2022

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A range of drugs have a direct role in triggering ischaemic priapism. We aimed at identifying: a)which medications are associated with most priapism-reports; and, b)within these medications, comparing their potential to elicit priapism through a disproportionality analysis. The FDA Adverse Event Reporting System (FAERS) database was queried to identify those drugs associated the most with priapism reports over the last 5 years. Only those drugs being associated with a minimum of 30 priapism reports were considered. The Proportional Reporting Ratios (PRRs), and their 95% confidence intervals were computed. Out of the whole 2015-2020 database, 1233 priapism reports were identified, 933 of which (75.7%) were associated with 11 medications with a minimum of 30 priapismreports each. Trazodone, olanzapine and tadalafil showed levels of disproportionate reporting, with a PRR of 9.

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Section: Discussionmentioning

confidence: 99%

Medications mostly associated with priapism events: assessment of the 2015–2020 Food and Drug Administration (FDA) pharmacovigilance database entries

et al. 2022

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“…The most common side effects are drowsiness, dry mouth, blurred vision, headaches, and falls [22]. Less common side-effects include priapism, a persistent painful penile or clitoral erection; the penile erection can lead to impotence in men [23][24][25][26][27][28] It is important to note that the view that the clinical evidence does not support trazodone as a treatment for first-line treatment for insomnia was the majority view of our sleep expert appraisal panel, but it was not the universal view. One expert appraisal panel member disagreed with the statement.…”

Section: Discussionmentioning

confidence: 99%

Should Trazodone Be First-Line Therapy for Insomnia? A Clinical Suitability Appraisal

Pelayo

Bertisch

Morin

et al. 2023

JCM

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Trazodone is one of the most commonly used prescription medications for insomnia; however, some recent clinical guidelines do not recommend its use for treating insomnia. This clinical appraisal critically reviews the scientific literature on trazodone as a first-line treatment for insomnia, with the focus statement “Trazodone should never be used as a first-line medication for insomnia.” In addition, field surveys were sent to practicing physicians, psychiatrists, and sleep specialists to assess general support for this statement. Subsequently, a meeting with a seven-member panel of key opinion leaders was held to discuss published evidence in support and against the statement. This paper reports on the evidence review, the panel discussion, and the panel’s and healthcare professionals’ ratings of the statement’s acceptability. While the majority of field survey responders disagreed with the statement, the majority of panel members agreed with the statement based on the limited published evidence supporting trazodone as a first-line agent as they understood the term “first-line agent”.

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“…[ 23 ] Apart from the emergent therapy required in its management, priapism carries a medical liability risk in cases of delay, omission, or neglect. [ 24 ]…”

Section: Introductionmentioning

confidence: 99%

“…[23] Apart from the emergent therapy required in its management, priapism carries a medical liability risk in cases of delay, omission, or neglect. [24] A limited number of cases of COVID-19 with coexisting priapism have been reported. [6][7][8][9][10][11][12][13][14][15][16][17][18][19] These cases must be reviewed to identify whether there is a potential association between these two conditions.…”

Section: Introductionmentioning

confidence: 99%

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Coronavirus disease 2019 (COVID-19) and priapism: An unexplored association

et al. 2022

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Background: Coronavirus disease 2019 (COVID-19) has an established impact on multiple organ systems, including the vascular and urogenital systems. Vascular effects may include venous thromboembolic disease, which could theoretically be a precursor to priapism—a urological emergency defined as an abnormal condition of prolonged penile erection lasting >4 hours. To better explore this association, we critically appraised all the published COVID-19 cases associated with priapism. Materials and methods: After PROSPERO registration ( CRD42021245257), a systematic search of Google Scholar, Scopus, Embase, Web of Science, PubMed, Cumulative Index to Nursing and Allied Health Literature, Global Index Medicus, and Cochrane Database of Systematic Reviews was performed using specific search terms. The following study metadata were extracted: age, requirement for respiratory support, cavernous blood gas findings, management of priapism, and patient outcomes. Results: Fifteen single-patient case reports were included in this review. Of these, all of the patients presented with ischemic priapism, 9 patients (60.0%) were >60 years of age, 4 (26.7%) reported more than a single episode of priapism, 11 (73.3%) presented with pneumonia, 8 (53.3%) required mechanical ventilation, D-dimer was elevated in 5 of the 6 (83.3%) patients in whom this was reported, and among the 13 patients in whom mortality was reported, 4 (30.8%) died. Conclusions: Early reports suggest a prognostic relationship between COVID-19 and coexisting priapism. However, owing to commonalities in their pathophysiology and the small dataset reported in the literature, the probable association between COVID-19 and priapism is still theoretical. Further research is needed to confirm this association.

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Review of Priapism Litigation in the United States

Cited by 4 publications

References 6 publications

Medications mostly associated with priapism events: assessment of the 2015–2020 Food and Drug Administration (FDA) pharmacovigilance database entries

Medications mostly associated with priapism events: assessment of the 2015–2020 Food and Drug Administration (FDA) pharmacovigilance database entries

Should Trazodone Be First-Line Therapy for Insomnia? A Clinical Suitability Appraisal

Coronavirus disease 2019 (COVID-19) and priapism: An unexplored association

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