藻酸双酯钠致阴茎异常勃起3例

3例男性患者，年龄为38，46和41岁，静脉输注藻酸双酯钠100mg／d。输注2～4d后患者出现阴茎异常勃起，持续24～72h。给予阴茎冷敷、加压、抽血、肝素氯化钠溶液冲洗，多巴胺海绵体注射，口服地西泮。之后，患者症状缓解。     

海绵体内注射血管活性药物致阴茎持续勃起9例

对121例阳痿患者海绵体内注射罂粟碱或罂粟碱加酚妥拉明合剂诱发勃起,结果有9例出现阴茎持续勃起(7.4％)。其治疗主要是加强下肢活动,阴茎海绵体抽血和注入阿拉明等,本组9例均治愈。临床观察也表明持续勃起在24h以内者应首选加强下肢活动,其次采用抽血、注入α-肾上腺素能药物,无效时行手术治疗,文中强调药物选择和用药剂量的重要性。     

Priapism complicating chronic granulocytic leukemia

Since 1952 we have seen nine patients with priapism leading to a diagnosis of chronic granulocytic leukemia (CGL) and a tenth patient who gave a history of priapism when CGL was diagnosed as a result of other symptoms. Seven patients had had one or more transient episodes of prolonged erection before the diagnosis of CGL was established. All ten had high blood leukocyte counts (mean 380 × 10⁹/liter, range 186-782) in comparison with other newly diagnosed patients. We estimate the incidence of this complication at 1%–2% of all male patients presenting with CGL. Treatment of patients in this series varied greatly. Five patients were treated mainly by local measures with or without cytotoxic drugs at conventional dosage, three were treated by sapheno-cavernous bypass operations and leukapheresis followed by cytotoxic drugs at high dosage, and two were treated initially by leukapheresis alone. In general, the prompt initiation of measures designed to reduce the leukocyte count seemed more valuable than the surgical procedures employed in these patients.     

Bilateral superselective arterial microcoil embolisation in delayed post-traumatic high flow priapism

High flow arteriogenic priapism is uncommon and usually occurs after trauma to the genitoperineal area. The onset of prolonged erection can be delayed and is often relatively pain free. Arteriography in this case illustrated the causative bilateral arteriocavernosal fistulae and pseudoaneurysms. Treatment consisted of staged bilateral superselective metallic microcoil embolisations, resulting in prompt detumescence. There were no complications. The patient had normal erectile function six months later. Recent concerns about erectile dysfunction with the bilateral use of permanent metallic coils appear to be unfounded.     

高流量性阴茎异常勃起1例报告及文献复习

目的通过病例报告及复习相关文献,探讨高流量性阴茎异常勃起的诊断及治疗。方法回顾性分析兰州军区兰州总医院近期收治的1例外伤后高流量性阴茎异常勃起患者的症状、体征、检查以及治疗、随访情况,结合既往报道的文献资料进行综述分析。结果患者入院后保守治疗无效,行超选择性阴部内动脉造影检查明确双侧阴茎海绵体动脉瘘,使用明胶海绵栓塞后治愈,随访6月患者恢复佳,无勃起功能障碍。结论通过典型的临床表现、阴茎海绵体血气分析以及彩色多普勒超声检查可初步诊断,而高选择性血管造影检查及栓塞术则为高流量性阴茎异常勃起的确定诊断及治疗的最常用及有效的方法。     

Reversed priapism,thrombosis of the dorsal penile vein: A case report

Priapism is an unintentional prolonged penile erection, lasting equal to or greater than 4 hours, in the absence of sexual stimulation or after having finished it. It is a rare pathology that can represent a urological emergency. The present report describes the case of a 25-year-old patient who presented priapism after suffering a one-meter fall on the genital area. Patient is a 25-year-old male with macroscopic hematuria without clots, testicular pain 4/10 on the numerical pain scale, stabbing type, without irradiation, secondary to a fall that occurred 3 months earlier, which resulted in a blow to the genital area. He presented an evolution of 20 days with detumescence and erectile dysfunction. Penile Doppler was performed and inverted priapism, arteriolacunar fistula at the base of the left corpus cavernosum, plus severe erectile dysfunction, were diagnosed. After a cavernography and an arteriography, a thrombolysis was performed. The patient continued with anticoagulant treatment with clopidogrel and enoxaparin and did not present complications after thrombolysis. A detailed clinical history, physical examination and a Doppler ultrasound study can provide a clear and timely diagnosis for the patient. Cavernography and arteriography have shown satisfactory results. In the present case, thrombolysis treatment with alteplase provided favorable results.