Sexual Function After Highly Selective Embolization of Cavernous Artery in Patients With High Flow Priapism: Long-Term Followup

Savoca, G.; Pietropaolo, F.; Scieri, F.; Bertolotto, Michele; Mucelli, Fabio Pozzi; Belgrano, E.

doi:10.1097/01.ju.0000132494.44596.33

Cited by 67 publications

(51 citation statements)

References 20 publications

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“…4 Recurrence rates are low (7%-27%). [12][13][14] Embolization in children, although successful, is technically challenging and requires treatment in a specialist pediatric vascular radiology department. 15,16 We report an interesting case of priapism, which was resistant to each treatment applied for the patient.…”

Section: Discussionmentioning

confidence: 99%

Resistant pediatric priapism: A real challenge for the urologist

Sekerci

Akbal

Şener

et al. 2015

CUAJ

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Priapism in pediatric patients is a rare entity. We present an 8-yearold boy with known cerebral palsy. He came to the emergency department with sustained painful erection for 12 hours. Physical examination showed rigid penis. Blood count and biochemical analysis were normal. Although penile Doppler ultrasound revealed normal arterial and venous flow, cavernosal blood gas was hypoxic. A total of 50 mL of dark blood was aspirated, and 2 mL of 0.001% adrenalin solution was applied to both corpus cavernosum, twice within 20 minutes, which eventually did not achieve detumescence. A distal Winter shunt was performed at the end of which the penis was semi-flaccid. By the 18th hour of surgery, the penis re-gained painful erection status, so an Al-Ghorab shunt was performed. After the Al-Ghorab shunt, the penis was still in the semi-flaccid state. The next day, an angiography was performed and an arteriovenous fistula was discovered and treated by embolization. The flaccid state was achieved and the patient was discharged the day after the embolization.

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Section: Discussionmentioning

confidence: 99%

Resistant pediatric priapism: A real challenge for the urologist

Sekerci

Akbal

Şener

et al. 2015

CUAJ

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“…Eredményte-lenség esetén a beavatkozás megismételhető. A beavatkozás után körülbelül 20%-ban alakul ki erektilis diszfunkció (16). Egyéb lehetséges szövődmények az artéria behatolási pontjá-nál keletkező haematoma, az intervenció során fellépő tromboembóliás szövődmények, hímvesszőn kialakuló gangréna, gluteális régió iszkémiája, cavernositis és perineális abscessus (17).…”

Section: Terápiaunclassified

High flow priapizmus két esete – diagnosztika és kezelés

Hüttl¹,

Kopa²,

Dósa³

et al. 2017

Magyar Urológia

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BevezetőPriapizmusnak nevezzük azt a kóros állapotot, amikor a hímvesz-sző legalább 4 órán keresztül vagy annál hosszabb ideig, ingerlés nélkül, erektilis állapotban van (1). A szakirodalom a priapizmust három csoportra osztja: vénás (low flow), artériás (high flow), valamint rekurrens vagy intermittáló. Az esetek 95%-a vénás tí-pusba tartozik, az artériás priapizmus ritka kórkép, hazánkban, ellátásában nincsen kialakult gyakorlat, sem adatok a kezelt betegek utánkövetésével kapcsolatban. 2015-ben a Semmelweis Egyetem Urológiai Klinikáján két esetben (továbbiakban "A" illetve "B" beteg) diagnosztizáltunk high flow priapizmust és a Vá-rosmajori Szív-és Érgyógyászati Klinika intervenciós radiológiai részlegének segítségével láttuk el a betegeket. Esetismertetés"A" beteg, 35 éves férfi, esetében a kórok kerékpáro-zás közben elszenvedett gáttáji sérülés volt. "B" beteg, középkorú férfi, vesetumor miatt onkológiai ke-

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“…Insgesamt ist die Prognose des nicht ischämischen High-flow-Priapismus nach Embolisation als gut zu werten und mit dem Erreichen einer vollständigen Detumeszenz bei gleichzeitigem Erhalt der erektilen Funktion in bis zu 80-89% der Fälle zu rechnen [1,2].…”

Section: Second-line-therapieunclassified

Diagnostik und Therapie des Priapismus

Kaminsky

Sperling

2015

Urologe

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Priapism is defined as an erection for more than 4 h without sexual stimulation. The most common form with nearly 95% is the ischemic or low-flow form, which is very painful. The other 5% are comprised of nonischemic high-flow type usually caused by a blunt perineal trauma and the recurrent or intermittent so-called stuttering priapism. Anamnesis as well as physical and laboratory examination are important during the diagnostic workup. Patients who suffer from sickle cell anemia are predestined to develop priapism. Priapism constitutes a urological emergency because especially the low-flow type has to be treated immediately to prevent a long-lasting fibrosis of the corpus cavernosa and a consecutive erectile dysfunction. The first step is the puncture and aspiration of blood from the corpus cavernosa if necessary combined with the injection of α-agonists. In case detumescence is not achieved, an operative shunt should be placed after an MRI. If there is a complete fibrosis of the corpus cavernosa possibly combined with penis deviation the implantation of a penile prosthesis is an option. The therapy of high-flow priapism is not as urgent as that of low-flow priapism because there is no risk of ischemia. If conservative therapeutic options fail, the superselective embolization of the fistula is the treatment of choice. In recurrent or intermittent priapism, the goal is to avoid new episodes with drug treatment. Because of the low incidence of priapism, it is very difficult to recommend and favor one therapeutic procedure.

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Sexual Function After Highly Selective Embolization of Cavernous Artery in Patients With High Flow Priapism: Long-Term Followup

Abstract: Highly selective embolization of the fistula is an effective and safe treatment option for high flow priapism because it ensures a high level of preservation of pretreatment erectile function.

Cited by 67 publications

References 20 publications

Resistant pediatric priapism: A real challenge for the urologist

Resistant pediatric priapism: A real challenge for the urologist

High flow priapizmus két esete – diagnosztika és kezelés

Diagnostik und Therapie des Priapismus

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