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.     

Conservative management of priapism secondary to leukemia

We report four cases of leukemia (three chronic myeloid and one T-cell acute lymphoblastic) presenting with priapism in children 9- to 13-year old. All of them presented with hyperleukocytosis, and three had anemia plus thrombocytosis. All patients underwent chemotherapy and two had leukopheresis. In all cases, priapism was managed conservatively. Erection required up to 13 days to start improving but none of the patients developed clinical evidence of long-term erectile dysfunction. Based on these cases, conservative management of priapism in children with leukemia might be adequate and not lead to long-term erectile dysfunction.     

阴茎异常勃起的鉴别诊断及急诊处理

目的:提高阴茎异常勃起的诊治水平。方法:对18例阴茎异常勃起患者的诊断和治疗进行了回顾性分析。结果:发病原因:白血病1例,海绵体注射罂粟碱16例,原因不明1例。发病至就诊时间4~18 h,平均7 h。均为低流量异常勃起。海绵体穿刺血液行血气分析3例,海绵体动脉血流彩色多普勒检查2例。17例经阴茎海绵体内注射缩血管药物、海绵体穿刺放血以及肝素化盐水冲洗后异常勃起消失。1例白血病诱发勃起的患者经上述治疗无效,后经化疗后恢复正常。结论:海绵体内注射罂粟碱诱发的阴茎异常勃起和白血病诱发的异常勃起均为低流量型异常勃起。阴茎海绵体内注射缩血管药物,海绵体穿刺放血冲洗可解除异常勃起。白血病诱发的异常勃起应强调原发病的治疗。     

A rare entity: idiopathic priapism in a newborn and review of the literature

Priapism is a pathological condition of a penile erection that persists beyond or is unrelated to sexual stimulation. Priapism is an important medical condition, which requires evaluation and may require emergency management. This condition occurs very infrequently in paediatrics outside of the sickle-cell population and is exceedingly rare in newborns. The evaluation and management of neonatal priapism can be challenging for paediatricians, neonatologists and paediatric urologists alike given the lack of experience with this condition, its poorly understood pathophysiology and the absence of well-established guidelines. We present a case of idiopathic neonatal priapism because of its rarity and review of the literature.     

Rare Disorders of Painful Erection: A Cohort Study of the Investigation and Management of Stuttering Priapism and Sleep-Related Painful Erection

BackgroundA chief complaint of men with stuttering priapism (SP) and sleep-related painful erections (SRPE) is bothersome nocturnal erections that wake them up and result in poor sleep and daytime tiredness. SP and SRPE are rare entities that have similarities in their clinical features, but that require different treatment approaches.AimThe aim of this study was to describe the clinical features, investigations, and effective management options for men with SP and SRPE.MethodsRetrospective cohort study of 133 men with bothersome nocturnal painful erections that attended a tertiary andrology unit between 2004 and 2018. These men were divided into 3 groups. Group 1 (n = 62) contains men with sickle cell SP; group 2 (n = 40) has men with non-sickle cell SP and group 3 (n = 31) contains men with SRPE.OutcomeTo determine the effectiveness of medical and surgical treatments for men with SP and SRPE.ResultsHydroxyurea and automated exchange transfusion were the most effective treatment options in the sickle cell SP group. Hormonal manipulation and α-agonist therapies were effective in both SP cohorts (groups 1 and 2). Baclofen was the most effective therapy in men with SRPE. For men who failed medical management, implantation of a penile prosthesis resulted in complete resolution of the symptoms in men with SP (groups 1 and 2). Surgical management (penile prosthesis implantation and embolization) did not improve the patients’ symptoms in the SRPE group.Clinical ImplicationsThis study differentiates between sickle cell SP, non-sickle cell SP, and SRPE and describes effective treatment options for each group.Strengths & LimitationsThis is the largest cohort study for both SP and SRPE, respectively. Limitations include its retrospective nature and single-center experience.ConclusionManaging men in these 3 groups differently and in accordance with the proposed treatment pathway provides a more structured approach to the management of these rare conditions.Johnson M, McNeillis S, Chiriaco G, et al. Rare Disorders of Painful Erection: A Cohort Study of the Investigation and Management of Stuttering Priapism and Sleep-Related Painful Erection. J Sex Med 2021;18:376–384.     

A case of proximal partial priapism successfully treated with autologous clot embolisation

Partial priapism is a rare disorder in literature and generally described as a contusion or thrombosis of the cavernous body of the penis secondary to blunt trauma. Because of the rarity of disease, there is not much information about the treatment. Conservative management with nonsteroidal anti-inflammatory drug is often applied treatment. Here, we presented a proximal partial priapism treated successfully with autologous clot embolisation secondary to pelvic trauma.     

高流量阴茎异常勃起的诊断和治疗(附5例报告)

目的 探讨高流量阴茎异常勃起的诊断和治疗.方法 总结我院自2001年至2007年收治的5例高流量阴茎异常勃起病例的病因、诊疗过程,并检索CNKI<中国期刊全文数据库>2001年-2007年文献,荟萃分析高流昔阴茎异常勃起的病因、诊断和治疗方法.结果 4例患者为会阴部外伤,1例为性交后出现.3例行高选择性阴部内动脉造影术及可吸收性明胶海绵选择性阴部内动脉栓塞术,随访8～12个月,勃起功能恢复;其余2例等待观察,随访12个月,勃起功能恢复.结论 高流量阴茎异常勃起诊断主要依据体格检查、阴茎海绵体超声、海绵体血气分析.不需急诊治疗,应依据患者要求,选择保守治疗或动脉栓塞术.     

The dreadful and the deadly erection—Malignant priapism from renal cell carcinoma

Penile metastasis of renal cell carcinoma is a rare occurrence. We report a case in a 44-year-old man who presented with malignant priapism as the first sign of recurrence of renal cell carcinoma. Although invasive procedures have a limited role in survival benefits, we performed a total penectomy to alleviate pain and provide a better quality of life.     

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.