Post-traumatic high flow priapism: A case report

A case of post-traumatic high flow priapism in a 32-year-old man is reported. The diagnosis was based on cavernous blood gas analysis and left internal pudendal arteriography. He was treated by unilateral super-selective embolization of the fistula with coils and gelatin sponge. At 1 month after embolization, erectile function had recovered, as demonstrated by measurement of nocturnal penile tumescence.     

Post-surgical high-flow priapism treated by embolization

Perineal and penile traumas are the commonest cause of high-flow priapism. The clinical symptom of this disease is generally a prolonged, painless, and semirigid penile erection without any other urogenital symptoms. In contrast, high-flow priapism is a quite uncommon condition after transurethral surgery and it may be presented with an unusual clinical manifestation. Herein, we report the first case of priapism associated with massive urethral hemorrhage requiring blood transfusion after internal urethrotomy. High-flow priapism was successfully treated by autologous clot embolization and the priapism associated with massive urethral hemorrhage resolved.     

高流量性阴茎异常勃起的诊治(附3例报告)

目的 探讨高流量性阴茎异常勃起的诊断和治疗方法。方法 复习3例高流量性阴茎异常勃起，2例会阴部外伤所致，1例原因不明。行体检、血气分析、阴茎彩色超声、阴部内动脉血管造影等检查，并分别行阿拉明注射、穿刺放血、阴茎头．阴茎海绵体分流、明胶海绵动脉瘘栓塞等治疗。结果 2例明确诊断为高流量性阴茎异常勃起，右侧动脉瘘栓塞后勃起完全消失，随访短期内勃起功能恢复。1例诊断模糊，行分流手术后勃起不完全消退，随访2年内发生勃起功能障碍。结论 选择性阴部内动脉造影和栓塞治疗是高流量性阴茎异常勃起有效的诊治方法。     

Utilization of a topical autologous blood clot for treatment of pressure ulcers

Management and treatment of pressure ulcers (PUs) are met with great difficulty due to various factors that cause vulnerability of the soft tissue such as location, limited mobility, increased friction and shearing forces, as well as other comorbidities that may delay or halt wound healing. The topical autologous blood clot therapy (TABCT) is a point-of-care treatment used as a blood clot to assist in recreating and repairing the extracellular matrix (ECM). The mechanism of action consists of reconstruction of the ECM by incorporating into the ulcer, providing protection from further external destruction, while assisting in advancement through the wound healing phases via interaction of necessary growth factors, mediators, and chemokines. This study aims to assess the efficacy of the TABCT in the treatment of PUs in comparison to standard of care (SOC) treatment. Twenty-four patients, 18 years or older, with PUs ranging from stage 1 to 4, were included in this study. TABCT was created by using the patient's own peripheral blood in a point of care setting. Efficacy in percent area reduction (PAR) on weeks 4 and 12 with TABCT over SOC was assessed. Treatment using TABCT in PUs resulted in 77.9% of the patients achieving a 50% PAR on week 4. The mean PAR on week 12 was 96.23% with 45% of the wounds treated with TABCT achieving complete wound closure. TABCT exhibited efficacy in PAR of PUs. In addition, TABCT use prompted granulation tissue formation over vital structures, such as bone, which is often present in later stage PUs. The potential of bringing an affordable, cost-effective, advanced biologic bedside treatment that is efficacious in resolution of these complex wounds has the potential to drastically reduce the burden of treatment on the health system.     

Idiopathic stuttering priapism treated with salbutamol orally: a case report

Recurrent ischaemic priapism also known as stuttering priapism is an uncommon form of ischaemic priapism, and its treatment is not yet clearly defined. If left untreated, it may evolve into classic form of acute ischaemic priapism and lead to erectile dysfunction due to fibrosis of corpora cavernosa. Several drugs have been proposed with variable results and only supported with level three or four of evidence. Hormonal therapy such as cyproterone acetate, oestrogen, bicalutamide or Lh‐Rh agonist are often effective but can cause side effects such as hypogonadal state and infertility. Other medical options are 5‐alpha‐reductase and phosphodiesterase‐5 inhibitors, ketoconazole, baclofen, digoxin, gabapentin and beta‐2‐agonist terbutaline. We report the first case of stuttering priapism treated with beta‐2‐agonist salbutamol.     

A case report on idiopathic recurrent priapism

Idiopathic recurrent priapism is a difficult problem to treat and a potentially devastating condition that may result in irreversible penile fibrosis. We present the case of a patient who, during a period of 10 years, had recurrent episodes of idiopathic priapism and we show that therapeutic options do exist for the management.     

Partial priapism secondary to tamsulosin: a case report and review of the literature

Partial priapism is also called partial segmental thrombosis of the corpus cavernosum. It is a rare pathology, and its aetiology, physiopathology and treatment are still not completely understood. To our knowledge, partial priapism due to alpha blockers has not been reported previously in the literature. In this study, a successfully treated case of partial priapism occurring after the usage of alpha blocker is presented and discussed in light of the related literature.     

Acenocoumarol associated priapism: report of a case

We report on a 20-year-old man presenting with priapism while receiving oral acenocoumarol for the treatment of deep vein thrombosis. To the authors' knowledge, it is the first reported case of acenocoumarol-associated priapism.     

A CASE OF ARTERIAL PRIAPISM TREATED BY EMBOLIZATION

An 18-year-old unmarried man, who had shown arterial priapism caused by mild perineal trauma sustained during skate-boarding, has been successfully treated by autologous clot embolization at the common penile artery. He was able to have a normal erection and ejaculate 5 d after embolization.     

自体脂肪颗粒在轻度偏颌畸形微创修复中的应用

目的:探讨自体脂肪颗粒在下颌偏颌轮廓微创修复中的应用。方法:根据下颌偏斜程度、脸型、个人要求等因素,设计出下颌部高度、翘度、宽度及形态,获取和纯化自体脂肪颗粒,于颏上点下方作穿刺点,将脂肪注入下颌缺陷部骨膜上方和皮下层并塑形。结果:术后随访3个月~1年,下颌部塑形满意,无血肿、感染、硬结、脂肪液化等并发症。结论:自体脂肪颗粒移植具有取材方便,微创,不留痕迹,效果逼真等优点,是偏颌微创修复中能改善面下1/3轮廓不对称的一种较好方法。     

Microsurgical management of a complicated aneurysmal endovascular embolisation with GDC coil: A case report

We present a case involving a microsurgical approach to solving the problem of a medical cerebral artery (MCA) occlusion occuring after GDC coiling of an internal cerebral artery (ICA) bifurcation aneurysm in a 40 year old woman. We describe the clinical course of the case and discuss technical possibilities and risks of clipping a coiled aneurysm. One key to success is awareness of changes in the aneurysm's properties after coiling. With loss of elasticity the aneurysm had the effect of a tumor fixed on the vessel. The apposition of the aneurysm to the wall of the vessel, as well as the aneurysm's rigidity and increase of intracranial pressure after subarachnoideal hemorrhage (SAH), may lead to occlusion of the vessel. In cases of an mandatory operation due to the occlusion of a main arterial stem after coiling, it is primarily crucial to perforate the aneurysm's fundus, remove the coils, and, finally, to clip the slack neck of the aneurysm. An attempt to precisely prepare and clip the aneurysmal neck without removing the coils could result in the rupture of the aneurysm's neck.     

An alternative noninvasive approach for the treatment of high-flow priapism in a child: duplex ultrasound-guided compression

We are presenting a 5-year-old boy with a traumatic high-flow priapism developed after a straddle injury and successfully treated by compression and simultaneous monitoring with a duplex ultrasound probe. We believe that this may be an alternative method against conventional treatment modalities including conservative follow-up, sympathomimetic drug administration, percutaneous embolization of the fistula, and surgical ligation.     

A successfully treated case of blunt traumatic right coronary ostium rupture

Cardiac tamponade due to coronary artery rupture, as a consequence of blunt trauma, is a rare but usually fatal condition. We successfully obtained primary hemostasis with emergency room thoracotomy, followed by delayed definitive treatment of the ruptured right coronary artery ostium in a motor vehicle accident victim with multifocal hemorrhagic lesions. Survival of patients with the described serious trauma has not been reported, and we discuss herein our treatment strategy.     

Multifragmentary proximal humerus fracture successfully treated with k-wire fixation: A case report

Introduction and importanceThe ideal treatment of proximal humerus fracture remains a controversial topic, especially in the case of complex multi-fragmentary fractures. However, in limited resource settings, alternative less complicated fixation may be considered in highly selected patients without compromising the functional outcome. We report a case of successful treatment with k-wire fixation with satisfactory functional outcome.Case presentationA 22-year-old female presenting with a right-sided closed multi-fragmentary proximal humerus fracture following a motor vehicle collision. A complex multi-fragmentary right-sided proximal humerus fracture (AO 11C3, Codman-Hertel type 12) was diagnosed based on the shoulder x-ray and computed tomography 3-dimensional reconstruction. She underwent an open reduction and k-wire fixation under image guidance. She had satisfactory functional outcome 6 months after surgery with painless near-total range of motion.Clinical discussionThe ongoing debate of the optimal surgical management for complex proximal humerus fractures implies that the best treatment should be made on an individual basis. The probable reason for the good outcome in our patient may be the combination of intact blood supply and periosteum, intact rotator cuff mechanism, young patient with healthy bone metabolism and achievement of good reduction with restoration of the articular surface and calcar.ConclusionAlthough this successful case of k-wire fixation is not sufficient to challenge the option of primary arthroplasty, this low cost, readily, available simple strategy may be useful in highly selective instances.     

A rare cause of recurrent priapism: hereditary angioedema

Hereditary angioedema is a rare disease, which is caused by deficiency of compleman c1 esterase inhibitor regulatory protein in the compleman system. Priapism is involuntary, painful and prolonged erection of penis more than 4 h without sexual desire. In this case report, we elucidated a patient diagnosed with hereditary angioedema while he had recurrent priapism.     

Arthroscopic meniscus repair and augmentation with autologous fibrin clot in Indian population: A 2-year prospective study

IntroductionThis study was proposed to evaluate the efficacy of fibrin clot augmentation in meniscal tear using inside-out meniscal repair.MethodsA total of 35 patients with meniscus tears were operated on with inside-out meniscus repair and fibrin clot augmentation. Patients were evaluated preoperatively and postoperatively with clinical criteria, Lysholm knee scoring system, and MRI.ResultsOut of the total 35 cases, 5 cases were lost to follow-up. Clinical improvement was observed in 29 out of 30 patients (96.6%). The mean Lysholm score improved significantly from 67.63 ± 6.55 points preoperatively to 92.0 ± 2.9 points postoperatively (P < 0.05) in 3 years follow-up. Follow-up MRI in all patients revealed complete healing except in 1 case where the patient presented with recurrence of symptoms such as pain and locking which resolved with partial meniscectomy. Paraesthesia in the anterior part of the knee was observed in 2 cases. (6.6%).ConclusionWe conclude that fibrin clot augmentation is a good cost-effective modality of treatment for repairable meniscus tears to preserve the meniscus and decrease the point contact pressure on the condyles which may prevent the early occurrence of osteoarthritis.     

A case of priapism successfully managed by local irradiation]

A 42-year-old man with priapism is reported. The condition did not improve by cavernous body irrigation with heparin, intravenous administration of anticoagulant, or various surgical shunt operations. However, the condition improved after local radiation therapy: a total dose of 6Gy, 1.5 Gy daily for 4 days, was given to a site 24 cm x 24 cm which covered the small pelvic cavity and the femoral area centering around the root of the penis. Improvement of the condition became evident from Day 3 of radiation therapy. For about 1 year since then the patient has been entirely free of recurrence.     

Management of post-traumatic arterial priapism in children: Presentation of a case and review of the literature

In this article, a 9-year-old boy with arterial priapism is presented. The patient was managed with the conservative measures including imipramine hydrochloride and a favorable outcome was achieved after 2 months of follow-up. The pathophysiology, diagnostic tools and treatment alternatives are discussed.