Portal de Periódicos da CAPES

COCAINE ASSOCIATED PRIAPISM

1999; Lippincott Williams & Wilkins; Volume: 161; Issue: 6 Linguagem: Inglês

10.1016/s0022-5347(05)68812-x

1527-3792

Andrew Altman, Allen D. Seftel, SCOTT L. BROWN, Nehemia Hampel,

Urinary Bladder and Prostate Research

No AccessJournal of UrologyClinical Urology: Original Articles1 Jun 1999COCAINE ASSOCIATED PRIAPISM ANDREW L. ALTMAN, ALLEN D. SEFTEL, SCOTT L. BROWN, and NEHEMIA HAMPEL ANDREW L. ALTMANANDREW L. ALTMAN , ALLEN D. SEFTELALLEN D. SEFTEL , SCOTT L. BROWNSCOTT L. BROWN , and NEHEMIA HAMPELNEHEMIA HAMPEL View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)68812-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Cocaine abuse is an ongoing epidemic in the United States. Priapism associated with cocaine use has been reported only twice in the urological literature. To our knowledge we report the first series of priapism associated with cocaine use and the first case associated with the use of this drug in its solid form, known as crack. Materials and Methods: We retrospectively reviewed the presentation of 3 patients to our emergency department within the last year. Each patient presented with priapism and no identifiable predisposition other than the use of cocaine within 24 hours, as evident on positive urine toxicology. Results: Each patient delayed seeking treatment, which added to the complexity of therapy. Intracavernosal aspiration and irrigations failed in all 3 cases. Cavernous spongiosal shunting failed in the first 2 cases. Cases 2 and 3 were complicated by the high flow variant of priapism. Case 1 ultimately required partial penectomy for infected, gangrenous, distal penile tissue. Conclusions: It appears that cocaine can be a cause of refractory priapism and treatment can be challenging. We suggest that urine toxicology screening be considered in such cases. The identification of underlying cocaine abuse is important in preventing priapism recurrence in these patients. References 1 : Priapism associated with intranasal cocaine abuse. J. Urol.1990; 143: 584. Abstract, Google Scholar 2 : Priapism associated with the use of topical cocaine. J. Urol.1990; 143: 358. Google Scholar 3 : . Philadelphia: W. B. Saunders1995: 518. Google Scholar 4 : Cocaine use and characteristics of young adult users from 1987 to 1992: the CARDIA study. Amer. J. Pub. Health1996; 86: 1736. Google Scholar 5 : Effects of intranasal cocaine on sympathetic nerve discharge in humans. J. Clin. Invest.1997; 99: 628. Google Scholar 6 : Vasospasm and thrombus formation as possible mechanisms of stroke related to alkaloidal cocaine. Stroke1995; 26: 1114. Google Scholar 7 : Cocaine-induced myocardial ischemia and infarction: pathophysiology, recognition, and management. Prog. Cardiovasc. Dis.1997; 40: 65. Google Scholar 8 : Mesenteric ischemia secondary to cocaine abuse: case reports and literature review. Amer. J. Gastroenterol.1997; 92: 1053. Google Scholar 9 : The interaction of cocaine with central serotonergic neuronal systems: cellular electrophysiologic approaches. Natl. Inst. Drug Abuse Res. Monogr.1988; 88: 78. Google Scholar 10 : Response of native and stimulated collateral vessels to serotonin. Amer. J. Physiol.1997; 272: H2409. Google Scholar 11 : High flow priapism complicating venoocclusive priapism: pathophysiology of recurrent idiopathic priapism?. J. Urol.1998; 159: 1300. Link, Google Scholar 12 : Traumatic laceration of intracavernosal arteries: the pathophysiology of nonischemic, high flow, arterial priapism. J. Urol.1990; 143: 129. Link, Google Scholar 13 : Ultrasonography of the urinary tract. In: . Philadelphia: W. B. Saunders1990: 319. Google Scholar From the Department of Urology, Case Western Reserve University, Cleveland, Ohio© 1999 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 161Issue 6June 1999Page: 1817-1818 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.MetricsAuthor Information ANDREW L. ALTMAN More articles by this author ALLEN D. SEFTEL More articles by this author SCOTT L. BROWN More articles by this author NEHEMIA HAMPEL More articles by this author Expand All Advertisement PDF downloadLoading ...