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Recurrent Prolonged Erections and Priapism as a Sequela of Priapism: Pathophysiology and Management

1991; Lippincott Williams & Wilkins; Volume: 145; Issue: 4 Linguagem: Inglês

10.1016/s0022-5347(17)38445-8

1527-3792

Frederic J. Levine, Iñigo Sáenz de Tejada, Terry Payton, Irwin Goldstein,

Urinary Bladder and Prostate Research

No AccessJournal of Urology1 Apr 1991Recurrent Prolonged Erections and Priapism as a Sequela of Priapism: Pathophysiology and Management Frederic J. Levine, Iñigo Saenz De Tejada, Terry R. Payton, and Irwin Goldstein Frederic J. LevineFrederic J. Levine , Iñigo Saenz De TejadaIñigo Saenz De Tejada , Terry R. PaytonTerry R. Payton , and Irwin GoldsteinIrwin Goldstein View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)38445-8AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Veno-occlusive priapism may be associated with prolonged corporeal ischemia, subsequent fibrosis of the corpora and impotence. We report on 6 patients who presented with an unusual sequela of veno-occlusive priapism, recurrent episodes of prolonged erections or priapism. In all cases the subsequent episodes were idiopathic and veno-occlusive, occurred with a frequency ranging from several times per day to once per month and were symptomatically disabling. Pharmacocavernosometry ruled out mechanical occlusion of corporeal venous drainage by demonstrating elevated flows to maintain intracavernosal pressures following smooth muscle contraction and markedly decreased flow rates following smooth muscle relaxation. Treatment of the recurrent episodes with intracavernous self-injection of phenylephrine resulted in successful detumescence. The use of oral phenylpropanolamine reduced the frequency and duration of the recurrences, and markedly reduced the need for adrenergic self-injection. It is proposed that this syndrome may develop secondary to the initial ischemic episode, resulting in a functional alteration of the adrenergic and/or endothelialmediated mechanisms that control penile tumescence and maintain penile flaccidity. © 1991 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByBURNETT A (2018) Pathophysiology of Priapism: Dysregulatory Erection Physiology Thesis.Journal of Urology, VOL. 170, NO. 1, (26-34), Online publication date: 1-Jul-2003.ROURKE K, FISCHLER A and JORDAN G (2018) Treatment of Recurrent Idiopathic Priapism With Oral BaclofenJournal of Urology, VOL. 168, NO. 6, (2552-2553), Online publication date: 1-Dec-2002.RALPH D, PESCATORI E, BRINDLEY G and PRYOR J (2018) INTRACAVERNOSAL PHENYLEPHRINE FOR RECURRENT PRIAPISM: SELF-ADMINISTRATION BY DRUG DELIVERY IMPLANTJournal of Urology, VOL. 165, NO. 5, (1632-1632), Online publication date: 1-May-2001.GUPTA S, SALIMPOUR P, DE TEJADA I, DALEY J, GHOLAMI S, DALLER M, KRANE R, TRAISH A and GOLDSTEIN I (2018) A POSSIBLE MECHANISM FOR ALTERATION OF HUMAN ERECTILE FUNCTION BY DIGOXIN: INHIBITION OF CORPUS CAVERNOSUM SODIUM/POTASSIUM ADENOSINE TRIPHOSPHATASE ACTIVITYJournal of Urology, VOL. 159, NO. 5, (1529-1536), Online publication date: 1-May-1998.Hakim L, Kulaksizoglu H, Mulligan R, Greenfield A and Goldstein I (2018) Evolving Concepts in the Diagnosis and Treatment of Arterial High Flow PriapismJournal of Urology, VOL. 155, NO. 2, (541-548), Online publication date: 1-Feb-1996.Kim N, Jong Kim J, Hypolite J, Garcia-Diaz J, Broderick G, Tornheim K, Daley J, Levin R and De Tejada I (2018) Altered Contractility of Rabbit Penile Corpus Cavernosum Smooth Muscle by HypoxiaJournal of Urology, VOL. 155, NO. 2, (772-778), Online publication date: 1-Feb-1996.Brock G, Breza J, Lue T and Tanagho E (2018) High Flow Priapism: A Spectrum of DiseaseJournal of Urology, VOL. 150, NO. 3, (968-971), Online publication date: 1-Sep-1993.Pescatori E, Engelman J, Davis G and Goldstein I (2018) Priapism of the Clitoris: A Case Report Following Trazodone UseJournal of Urology, VOL. 149, NO. 6, (1557-1559), Online publication date: 1-Jun-1993.Seftel A, de Tejada I, Szetela B, Cole J and Goldstein I (2018) Clozapine-Associated Priapism: A Case ReportJournal of Urology, VOL. 147, NO. 1, (146-148), Online publication date: 1-Jan-1992.Beer S and See W (2018) Intracorporeal Needle Breakage: An Unusual Complication of Papaverine Injection Therapy for ImpotenceJournal of Urology, VOL. 147, NO. 1, (148-150), Online publication date: 1-Jan-1992. Volume 145Issue 4April 1991Page: 764-767 Advertisement Copyright & Permissions© 1991 by The American Urological Association Education and Research, Inc.Keywordspenile erectionphenylpropanolaminephenylephrinepriapismMetricsAuthor Information Frederic J. Levine More articles by this author Iñigo Saenz De Tejada More articles by this author Terry R. Payton More articles by this author Irwin Goldstein More articles by this author Expand All Advertisement Loading ...