精神药物所致阴茎异常勃起16例文献分析

目的探讨精神药物所致阴茎异常勃起的一般规律和特点,为临床合理用药提供参考。方法检索中国期刊全文数据库及万方数据库报道的16例精神药物所致阴茎异常勃起病例,对患者的年龄、原患疾病、既往史及药物过敏史、引起阴茎异常勃起的药物及剂量、发生阴茎异常勃起的时间、处理及预后等进行统计与分析。结果精神药物所致阴茎异常勃起16例病例中,引起阴茎异常勃起的精神药物以抗精神病药物及抗抑郁药居多。阴茎异常勃起出现时间服药后最短1h,最长为6年,用药1个月内发生者占68,75％。16例患者均停用致病药物,经局部冷敷、阴茎海绵体穿刺减压和血管活性药物局部注射、阴茎海绵体灌洗术、阴茎海绵体开窗减压、阴茎头阴茎海绵体分流术等处理,阴茎异常勃起在5h-10d恢复,其中2例（12．5％）后遗勃起功能障碍。结论临床医师、药师应了解精神药物所致阴茎异常勃起的规律和特点,加强用药监测,及时发现、及时处理。     

静脉阻塞性阴茎异常勃起17例诊治分析

目的:探讨静脉阻塞性阴茎异常勃起的诊断和治疗方法。方法:回顾性分析17例静脉阻塞性阴茎异常勃起患者的诊治方法。结果:17例患者均通过病史、体检、海绵体抽吸血气分析及多普勒超声检查确诊。经保守、海绵体抽吸、海绵体内注射药物及手术治疗后,17例患者中11例异常勃起完全消退,5例部分消退,1例因阴茎肿瘤治疗无效。随访2~6个月,其中3例出现ED。结论:阴茎海绵体血气分析、海绵体彩色多普勒检查对静脉阻塞性阴茎异常勃起有诊断价值,早期及正确应用海绵体注射药物和阴茎海绵体-尿道海绵体分流术是治疗静脉阻塞性阴茎异常勃起的可靠方法。     

右旋美托嘧啶用于静脉麻醉诱导后阴茎勃起的治疗与分析

目的：观察右旋美托嘧啶对全麻诱导后发生阴茎异常勃起治疗的有效性。方法：随机选择我院择期手术全身麻醉诱导后，外科医生行留置导尿术时发生阴茎勃起，5min内未自行消失的患者23例，按序贯法随机分为三组分别处理。C组：无特殊处理；D1组：静脉联合泵注右旋美托嘧啶0.5μg﹒kg-1﹒h-1；D2组：静脉联合泵注右旋美托嘧啶1μg﹒kg-1﹒h-1，直至阴茎疲软，分别记录完全疲软时间。结果：D2组勃起时间较C、D1两组明显缩短(P < 0.05)，C、D1两组勃起时间比较未见明显统计学差异(P > 0.05)。结论：全麻诱导后患者发生阴茎异常勃起时，采用静脉泵注较大剂量右旋美托嘧啶（1μg﹒kg-1﹒h-1）可获得快速显著的治疗效果。     

Relapsing erysipelas mimicking priapism 12 h after coitus

Background Erysipelas of the genital area can mimick priapism although it has not been reported in this context.
Subject In this paper we describe a patient with erysipelas of the genitals that was first diagnosed as priapism. 12 h after coitus the patient presented with night sweats, swelling in the genital area, with pain and an itching sensation. He had had recurrent erythema and massive swelling of his genitals since 1993. There was no history of injection into the penis and no entrance for an infection could be found at the penis and scrotum.
Treatment The patient was treated with cefotaxime 3 × 2 g day⁻¹, and ciclopiroxolamine cream and chinolinol dressings.
Results The patient experienced a resolution of the swelling of penis and scrotum within 8 days.
Conclusion We conclude that in cases reminiscent of priapism erysipelas should be considered.     

Priapism: Etiology and Management

Priapism is a urologic emergency. All patients should receive prompt urologic consultation. Management is based on prompt recognition, differentiation between low- and high-flow priapism, reversal of any potential precipitating factors, and the use of corporal aspirationhigation combined with intracavernosal α-agonist injection therapy. It cannot be overemphasized that severely prolonged erections are associated with the development of irreversible problems with erectile function and, therefore, immediate and aggressive management is mandatory.     

Spontaneous detumescence and full restoration of erection in a patient with high‐flow priapism with persistent arterial–lacunar fistula after repeated selective embolisation—A case report

High‐flow priapism is a rare condition mainly caused by perineal trauma. Laceration of cavernosal artery results in a formation of arterial–lacunar fistula with unregulated blood flow causing prolonged erection. We present a case of a 25‐year‐old man with high‐flow priapism and concurrent erectile dysfunction treated with repeated selective embolisation with only a partial effect. When no further embolisation was possible, we assumed on conservative management even through the fistula was still present. Spontaneous detumescence occurred 9 months, and erectile function has fully restored 24 months after the injury. To the best of our knowledge, spontaneous detumescence with full restoration of erection even through the persistent arterial–lacunar fistula has not been reported previously. Therefore, we propose conservative approach after embolisation to be an option.     

阴茎异常勃起的诊断和治疗(附12例报告)

目的提高阴茎异常勃起的诊治水平。方法统计临床所见12例阴茎异常勃起患者，年龄20-62岁，平均44岁。持续勃起时间13-162h，平均25．4h。其中血管活性药物所致5例，膀胱癌转移至阴茎异常勃起1例，白血病1例，有外伤史者3例，不明诱因者2例。对异常勃起分型，治疗及预后进行分析。结果12例患者中9例为低流量型，3例为高流量型。随访2—26个月，9例低流量型患者中，5例经阴茎海绵体根部注射间羟胺2—6mg，必要时在阴茎头及阴茎海绵体根部置9号针头灌注肝素化生理盐水对冲治愈，其中2例发生勃起功能障碍（ED）；2例行阴茎海绵体与阴茎头血管分流术治愈，其中一例术后出现ED；因白血病引起的阴茎异常勃起1例，膀胱癌转移至阴茎1例，预后均不佳。3例高流量型患者中1例行选择性阴部内动脉栓塞后治愈，无ED；2例行保守治疗出院，均有ED发生。结论详细的病史、海绵体血气分析和彩色双功能超声等检查有助于阴茎异常勃起准确及时的诊断。阴茎异常勃起如保守治疗无效，应立刻进行手术治疗。关键词阴茎异常勃起，诊断，治疗     

Refractory priapism associated with ingestion of yohimbe extract

Extracts of the bark of the central African treePausinystalia yohimbe contain yohimbine, an indole alkaloid, which is used to treat erectile dysfunction. The reported side effects of over-the-counter preparations of yohimbine include gastrointestinal upset, anxiety, increased blood pressure, headache, agitation, rash, tachycardia, and frequent urination. In this report, we describe a severe case of intractable priapism associated with the ingestion of yohimbe extract. Management required insertion of a proximal cavernosal spongiosum shunt (Quackles shunt) in the operating room.     

Successful treatment of low-flow priapism associated with phenothiazine therapy

We present a case of low-flow priapism that was successfully treated. A 21-year-old man with a history of schizophrenia was admitted with a painful complete erection. He had taken propericiazine, phenothiazine derivatives, before hospitalization and was treated with a glandular-cavernosal shunt (El-Ghorab's procedure). Currently, he is able to have erections without any changes in his quality of life.