Pathophysiology of Priapism: Dysregulatory Erection Physiology Thesis.
2003; Lippincott Williams & Wilkins; Volume: 170; Issue: 1 Linguagem: Inglês
10.1097/01.ju.0000046303.22757.f2
ISSN1527-3792
Autores Tópico(s)Sexuality, Behavior, and Technology
ResumoNo AccessJournal of UrologyCLINICAL UROLOGY: Review Articles1 Jul 2003Pathophysiology of Priapism: Dysregulatory Erection Physiology Thesis. ARTHUR L. BURNETT ARTHUR L. BURNETTARTHUR L. BURNETT View All Author Informationhttps://doi.org/10.1097/01.ju.0000046303.22757.f2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: While a modest amount of medical literature has been written on the topic of priapism, reports heretofore have focused predominantly on diagnostic and management related aspects of the disorder, providing meager information in regard to its pathophysiology. Accordingly the intent of this review was to explore the etiological and pathogenic factors involved in priapism. Materials and Methods: The review entailed an overview of traditional and modern concepts that have been applied to the pathophysiology of priapism and an evaluation of assorted observational and experimental data relating to this field of study. The basic exercise consisted of a literature search using the National Library of Medicine PubMed Services, index referencing provided through the Historical Collection of the Institute of Medicine of The Johns Hopkins University and a survey of abstract proceedings from national meetings relevant to priapism. Results: Insight into the pathophysiology of priapism was derived from a synthesis of evolutionary clinical experiences, mythical beliefs, clinical variants and scientific advances associated with the field of priapism. The results can be summarized. 1) Clinicopathological manifestations of priapism support its basic classification into low flow (ischemic) and high flow (nonischemic) hemodynamic categories, commonly attributed to venous outflow occlusion and unregulated arterial overflow of the penis, respectively. 2) Factual information is insufficient to substantiate etiological roles for urethral infection, bladder distention, failed ejaculation, satyriasis and sleep apnea in priapism. 3) Features of the variant forms of priapism invoke changes in nervous system control of erection and penile vascular homeostasis as having pathogenic roles in the disorder. 4) Clinical therapeutic and basic science investigative studies have revealed various effector mechanisms of the erectile tissue response that may act in dysregulated fashion to subserve priapism. Conclusions: This exercise suggested that, while priapism is commonly defined in terms of adverse mechanical contexts affecting penile circulation, it may also be viewed at least in some situations as an unbalanced erectile response involving derangements in possibly diverse systems of regulatory control. An integrative scientific approach that encompasses tissular, cellular and molecular levels of investigation may allow further understanding of the pathophysiology of the disorder. Ongoing elucidation of this pathophysiology can be expected to promote the development of new priapism therapies. References 1 : Priapism and impotence in homozygous sickle cell disease. Arch Intern Med1980; 140: 1434. Google Scholar 2 : Priapism associated with the sickle cell hemoglobinopathies: prevalence, natural history and sequelae. J Urol1991; 145: 65. Link, Google Scholar 3 : Priapism: a refined approach to diagnosis and treatment. J Urol1986; 136: 104. 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Volume 170Issue 1July 2003Page: 26-34 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordshemodynamicspenispriapismpenile erectionmuscle, smoothMetricsAuthor Information ARTHUR L. BURNETT Financial interest and/or other relationship with Pfizer, Bayer and Lilly ICOS. More articles by this author Expand All Advertisement PDF downloadLoading ...
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