Materiały źródłowe

• #1 Priapism: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/10042-priapism

  Priapism needs immediate treatment. Without treatment, it can cause permanent damage. […] The following tips may help prevent priapism: Treat any conditions that may cause priapism. Use medications only as prescribed by a healthcare provider. Wear an athletic cup to protect your penis if you play sports or participate in other rigorous activities. […] Priapism is a medical emergency. If you have an erection without sexual arousal or stimulation that doesnt go away within a few hours, go to the emergency room immediately. The longer you wait, the greater your risk of permanent damage to your penis.

• #2 Priapism in hematological and coagulative disorders: an update – PubMed

  https://pubmed.ncbi.nlm.nih.gov/21403660/

  Priapism is a true urological emergency that is typified by a persistent and painful erection. […] However, in high-risk groups, prophylaxis must be encouraged. A number of prophylactic measures are emerging based on progress in the understanding of the pathophysiology of priapism in these particular patients. […] In this Review, priapism as it relates to hematological disorders is discussed, focusing on treatment and prophylaxis.

• #3 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/priapism

  Priapism is a persistent or prolonged erection in the absence of sexual stimulation that fails to subside. It can be divided into ischaemic, non-ischaemic and stuttering priapism. The guidelines are based on three systematic reviews addressing the medical and surgical management of ischaemic and non-ischaemic priapism and the overall management of priapism related to sickle cell disease. […] Ischaemic priapism is a persistent erection marked by rigidity of the corpora cavernosa and by little or no cavernous arterial inflow. Ischaemic priapism is the most common subtype of priapism, accounting for 95% of all episodes. In ischaemic priapism, there are time-dependent metabolic alterations within the corpus cavernosum progressively leading to hypoxia, hypercapnia, glucopenia and acidosis. […] Ischaemic priapism that lasts beyond 4 hours is similar to a compartment syndrome and characterised by the development of ischaemia within the closed space of the corpora cavernosa, which severely compromises the cavernosal circulation. Emergency medical intervention is required to minimise irreversible consequences, such as smooth muscle necrosis, corporal fibrosis and the development of permanent erectile dysfunction (ED). The duration of ischaemic priapism represents the most significant predictor for irreversible consequences, thus including ED.

• #4 Priapism Treatment & Management: Approach Considerations, Prehospital Care, Low-Flow Priapism

  https://emedicine.medscape.com/article/437237-treatment

  Appropriate treatment of priapism varies, depending on whether the patient has low-flow or high-flow priapism. Most priapism cases are the low-flow, ischemic type. […] Treatment of low-flow priapism should progress in a stepwise fashion, starting with therapeutic aspiration, with or without irrigation, followed by intracavernous injection of a sympathomimetic agent (phenylephrine). […] Although all cases of priapism require prompt consultation with a genitourinary medicine specialist, emergency department (ED) personnel who have appropriate training and protocols may begin treatment with saline irrigation and injection. […] Patients should be on continuous telemetry, particularly if they are elderly or have cardiac risk factors. […] This procedure should be attempted for no more than approximately 60-90 minutes, and more advanced maneuvers (surgical shunts) may be indicated if no resolution occurs within this timeframe or in the case of prolonged ischemic priapism (24 hours).

• #5 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/priapism

  In this context, interventions beyond 48-72 hours of onset may help to relieve the erection and pain, but have little clinical benefit in preventing long-term ED. […] First-line medical treatments for ischaemic priapism of more than 4 hours duration are strongly recommended before any surgical treatment. Conversely, first-line treatments initiated beyond 48 hours, while relieving priapism, have little documented benefit in terms of long-term erectile function preservation. […] The first intervention for an episode of priapism lasting more than 4 hours consists of corporal blood aspiration to drain the stagnant blood from the corporal bodies, making it possible to relieve the compartment-syndrome-like condition within the corpus cavernosum. […] This combination is currently considered the standard of care for treatment of ischaemic priapism. Pharmacological agents include sympathomimetic drugs or -adrenergic agonists. Intracavernous sympathomimetic agents include phenylephrine, etilephrine, ephedrine, epinephrine, norepinephrine and metaraminol with a resolution rate of up to 80%.

• #6 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/priapism

  The primary goal in the management of patients with stuttering priapism is the prevention of further episodes and limiting the chances of developing a prolonged ischaemic priapism that is refractory to conventional treatment options. In most cases, stuttering priapism can be managed by pharmacological treatment. […] The management of each acute episode is similar to that for ischaemic priapism; aspiration/irrigation in combination with intracavernous injections of -adrenergic agonists. […] Studies of oral -adrenergic agonists have suggested some prophylactic benefit for daily treatment with these agents. Adverse effects include tachycardia and palpitations. […] The aim of hormonal manipulation is to down-regulate circulating testosterone levels to suppress the action of androgens on penile erection. This can be achieved by GnRH agonists or antagonists, antiandrogens or oestrogens.

• #7 Recurrent priapism: What is it, Causes, Preventions and Treatment

  https://dreminozbek.com/en/recurrent-priapism-what-is-it-causes-preventions-and-treatment-2/

  Recurrent priapism can have various underlying causes, and identifying the specific factor contributing to the repeated episodes is essential for effective management. Some common causes of recurrent priapism include: […] Preventing recurrent priapism involves identifying and addressing the underlying causes or risk factors that contribute to the condition. Here are some general strategies and preventive measures that may be considered: […] Its important to note that preventive measures will vary based on the specific underlying cause of recurrent priapism. Therefore, a personalized approach to prevention is crucial, and individuals should work closely with their healthcare providers to develop an effective and tailored plan based on their medical history and risk factors. Regular communication with urologist, adherence to prescribed treatments, and a healthy lifestyle are key components of preventing recurrent priapism. […] Prevention strategies include lifestyle modifications, adjusting medications, and regular medical follow-up. Early intervention and personalized care are essential for managing recurrent priapism effectively.

• #8 Priapism | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/priapism?content_id=CON-20164717

  Priapism is a prolonged erection of the penis. […] Prompt treatment for priapism is usually needed to prevent tissue damage that could result in the inability to get or maintain an erection (erectile dysfunction). […] If you experience recurrent, persistent, painful erections that resolve on their own, see your doctor. You might need treatment to prevent further episodes. […] If you have stuttering priapism, to prevent future episodes your doctor might recommend: Treatment for an underlying condition, such as sickle cell disease, that might have caused priapism, Use of oral or injectable phenylephrine, Hormone-blocking medications only for adult men, Use of oral medications used to manage erectile dysfunction.

• #9 Priapism Treatment & Management: Approach Considerations, Prehospital Care, Low-Flow Priapism

  https://emedicine.medscape.com/article/437237-treatment

  Treatment of high-flow priapism is initially conservative, as many cases will resolve spontaneously within several months. […] For persistent high-flow priapism, angiography with intervention to address arterial-spongiosum fistulae and/or pseudoaneurysm is the main treatment. […] In patients with priapism secondary to other disorders, attempt to treat the underlying condition whenever possible. […] Counseling for patients who are high risk for priapism is essential for prompt management. […] Prompt treatment and referral or consultation with a urologist is strongly encouraged. […] Any patient who has an erection for longer than 4 hours, especially if he has a predisposing illness (eg, sickle cell disease) should be advised to seek treatment for priapism. […] Examples of immediate treatment that can be suggested prior to arrival at the hospital may include the use of ice packs to the perineum and penis or asking the patient to walk up stairs.

• #10 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/priapism

  The potential treatment-related adverse effects of intracavernous phenylephrine (and other sympathomimetic agents) include headache, dizziness, hypertension, reflex bradycardia, tachycardia and palpitations and sporadic subarachnoid haemorrhage. […] The results of a systematic review on the overall management of priapism related to SCD found that few studies were conducted exclusively on patients with SCD and studies on mixed populations usually did not report separate data on SCD patients. […] Urgent intervention is essential and the general approach is similar to that described for other cases of ischaemic priapism and should be co-ordinated with a haematologist. […] However, as with other haematological disorders, other therapeutic interventions may also need to be implemented. Specific measures for SCD-related priapism include intravenous hydration and narcotic analgesia while preparing the patient for aspiration and irrigation.

• #11 Stuttering (recurrent ischaemic) priapism | Urology News

  https://www.urologynews.uk.com/features/synopsis/post/stuttering-recurrent-ischaemic-priapism

  The rationale for the use of PDE5i is based on the endothelial NOS knockout mice study described above. […] Patients with sickle cell recurrent ischaemic priapism may require red cell exchange transfusion. […] Hydroxyurea has also been found to significantly reduce the number of vaso-occlusive events in men with SCD. […] Men with symptoms refractory to medical management, or those that develop ED may be offered insertion of a penile prosthesis. […] Men with SP need to be followed up regularly to assess the effectiveness of the treatment and to assess the side-effects experienced.

• #12 Prolonged ischemic priapism in an adolescent with sickle cell anemia: Challenges of management – Journal of Case Reports and Images in Surgery

  https://www.ijcrisurgery.com/archive/article-full-text/100131Z12OA2024

  A potential role for anticoagulation and the use of low-dose hydroxyurea in the prevention of recurrent ischemic priapism in children with sickle cell anemia are advocated. […] Prevention of recurrence is an ever-present challenge in this child. He had unrecognized stuttering priapism. Stuttering priapism is the precursor of acute ischemic priapism. […] Though the use of hydroxyurea is controversial, it has shown proven benefits in the prevention of stuttering priapism and reversal of chronic organ damage including restoration of erectile function lost as a result of prolonged priapism. […] To minimize the risk of long-term sequelae, the child with prolonged ischemic priapism should proceed to percutaneous distal shunt with tunneling or open distal shunt with or without tunneling. The role of anticoagulation needs to be evaluated with prospective studies involving children. Prevention of recurrence of ischemic priapism in children with SCD is still problematic and we recommend the use of hydroxyurea.

• #13 Priapism and Sickle Cell Disease – Together by St. Jude™

  https://together.stjude.org/en-us/treatment-tests-procedures/symptoms-side-effects/priapism.html

  Priapism is a painful erection of the penis that lasts for an extended time. The erection is not related to sexual stimulus or arousal. […] Priapism can be very painful and is a serious condition. Long episodes of priapism can result in scarring and impotence (the loss of the ability to have an erection). […] If your child has an erection for more than 2 hours, take him to the emergency room for treatment. […] Medicines to treat priapism work best if given within the first 4 hours after the beginning of an acute episode. If it is not treated, it can result in permanent damage. […] Your child cannot prevent priapism. But some things may help. […] Discuss therapies with your child’s health care team. […] Monitor your child for any signs of infection or fever. […] Make sure your child drinks plenty of liquids. […] Have your child go to the bathroom before going to bed each night.

• #14 Priapism | Texas DSHS

  https://www.dshs.texas.gov/newborn-screening-program/sickle-cell-disease/more-about-sickle-cell/priapism

  Priapism is a persistent, unwanted erection of the penis. […] This type of priapism can usually be managed at home. Patients are encouraged to take warm baths, increase fluid intake and empty their bladder (urinate) often. […] This type of priapism needs attention by a doctor. Without medical treatment, severe priapism can lead to partial or complete impotence in over 80% of cases. […] There is no current program or therapy to prevent attacks of priapism. […] Patients with repeated attacks are encouraged to avoid long periods of bladder distention (not urinating for long periods of time), dehydration, and extended sexual activities.

• #15 Priapism (Penis Disorder): Treatment, Symptoms, Causes, Aspiration

  https://www.medicinenet.com/priapism_penis_disorder/article.htm

  Priapism or recurrence of priapism can be prevented by treating the underlying medical cause that resulted in priapism or changing medications that have priapism as their side effects. No medications should be discontinued or changed until you speak with your healthcare provider. […] Most clinicians consider priapism a medical emergency because the condition can result in impotence, sexual dysfunction or penile infection.

• #16 Medfin BlogPainful Erections- What You Need to Know

  https://www.medfin.in/blog/urology/painful-erections-what-you-need-to-know/

  Preventing painful erections, particularly priapism, involves addressing underlying causes and adopting healthy lifestyle habits. While not all causes of painful erections can be prevented, here are some preventive measures to consider: […] If you are taking medications known to have priapism as a side effect, discuss alternative medications or dose adjustments with your healthcare provider. Don’t modify your medication regimen without medical guidance. […] There is no foolproof way to prevent Peyronies disease, but maintaining overall penile health and minimizing the risk of penile trauma or injury during sexual activity may reduce the risk of developing this condition. […] Practicing safe sex and maintaining good genital hygiene can help reduce the risk of penile infections, which can contribute to painful erections.

• #17 Priapism | Patient Care

  https://weillcornell.org/services/urology/male-infertility-and-sexual-medicine/conditions-we-treat/priapism

  Priapism is defined as a prolonged erection developing in the absence of sexual stimulation and unrelieved by ejaculation. […] Proper categorization is essential, as the management of the two conditions is very different, particularly as ischemic priapism is a urologic emergency, while non-ischemic is not. […] Erectogenic medications are the most common cause of ischemic priapism in the adult United States population. […] Erections lasting longer than 4-6 hours are associated with permanent erection problems. […] The most important step in evaluating and treating a man with priapism is differentiating between ischemic and non-ischemic priapism. […] In the case of ischemic priapism, time is of the essence. […] The first step in treating ischemic priapism involves draining the old stagnant blood from the penis and injecting a vasoconstrictive medication directly into the erectile tissue (corpora cavernosum) of the penis. […] Non-ischemic priapism is not considered a urologic emergency. […] If a fistula is present the standard management is arterial embolization.

• #18 Medfin BlogPainful Erections- What You Need to Know

  https://www.medfin.in/blog/urology/painful-erections-what-you-need-to-know/

  Strategies for managing stress and anxiety, such as mindfulness, relaxation techniques, and counseling, can help prevent painful erections related to psychological factors. […] Attend routine health check-ups to monitor your overall health and detect underlying medical conditions that could lead to painful erections early. […] During sexual activity, be mindful of your physical safety to prevent traumatic injuries that can cause painful erections or penile fractures. […] Adopting a healthy lifestyle with regular exercise, a balanced diet, and maintaining a healthy weight can contribute to overall sexual health. […] It’s important to remember that while these preventive measures can reduce the risk of painful erections in some cases, it’s not always possible to completely prevent all causes. If you experience painful erections, seek prompt medical attention to identify the underlying cause and receive appropriate treatment. Early intervention is crucial in managing this condition effectively.

• #19 Priapism – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/priapism/

  Priapism is a prolonged erection of the penis. […] Prompt treatment for priapism is usually needed to prevent tissue damage that could result in the inability to get or maintain an erection (erectile dysfunction). […] If you experience recurrent, persistent, painful erections that resolve on their own, see your doctor. You might need treatment to prevent further episodes. […] If you have stuttering priapism, to prevent future episodes your doctor might recommend: Treatment for an underlying condition, such as sickle cell disease, that might have caused priapism; Use of oral or injectable phenylephrine; Hormone-blocking medications — only for adult men; Use of oral medications used to manage erectile dysfunction.

• #20 Priapism // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/priapism

  If you have stuttering priapism, to prevent future episodes your doctor might recommend: […] Treatment for an underlying condition, such as sickle cell disease, that might have caused priapism […] Use of oral or injectable phenylephrine […] Hormone-blocking medications only for adult men […] Use of oral medications used to manage erectile dysfunction.

• #21 Priapism Treatment & Management: Approach Considerations, Prehospital Care, Low-Flow Priapism

  https://emedicine.medscape.com/article/437237-treatment

  Oral pseudoephedrine (60 mg) can be recommended as an over-the-counter therapy the patient can take before or while traveling to the ED. […] If no resolution occurs within 30 minutes, injection therapy is required. […] Long-term, continuous use of phosphodiesterase type 5 (PDE5) inhibitors (eg, sildenafil), although off-label, has shown benefit in controlling recurrent ischemic priapism. […] A retrospective study of regimented PDE5 inhibitor dosing in patients with recurrent ischemic priapism found that of 24 evaluable patients, 22 (92%) reported improvement in priapism outcomes, with nine patients reporting resolution. […] Similarly, evidence supporting noninvasive treatment of ischemic priapism is sparse, but attempting it poses minimal risk as long as it does not delay the use of more definitive treatment.

• #22 Priapism (An Erection that Lasts Too Long) | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/patient-education/priapism

  Priapism is an erection that lasts too long. Priapism can develop without sexual stimulation and doesnt go away after orgasm. There is a risk of having priapism after penile injection therapy. […] If you have priapism, taking pseudoephedrine HCl (Sudafed) can help. […] If you have problems with your heart, talk with your cardiologist about whether its safe for you to take pseudoephedrine HCl. […] If you have an erection that lasts 4 hours and you havent talked to your APP, this is a medical emergency. You should treat it with the same urgency as a heart attack. Erections lasting longer than 4 hours can cause permanent damage to your erection tissue.

• #23 SciELO Brazil – Daily use of phosphodiesterase type 5 inhibitors as prevention for recurrent priapism Daily use of phosphodiesterase type 5 inhibitors as prevention for recurrent priapism

  https://www.scielo.br/j/ramb/a/PKwdjzFXvWWf7TFJPD4V5FB/

  Objective: The pathogenesis of recurrent priapism is currently being investigated based on the regulation of the phosphodiesterase 5 (PDE5) enzyme. We explored the daily use of PDE5 inhibitors to treat and prevent priapism recurrences. […] Conclusion: These findings suggest the hypothesis that PDE5 dysregulation exerts a pathogenic role for both sickle cell disease-associated priapism and for idiopathic priapism, and that it offers a molecular target for the therapeutic management of priapism. These preliminary observations suggest that continuous long-term oral PDE5 inhibitor therapy may treat and prevent recurrent priapism. […] The preventive strategy was based on previous reports on the feasibility of PDE5 for pharmacologic prevention of recurrent priapism in patients with SCD and hemoglobinopathies.

• #24 SciELO Brazil – Daily use of phosphodiesterase type 5 inhibitors as prevention for recurrent priapism Daily use of phosphodiesterase type 5 inhibitors as prevention for recurrent priapism

  https://www.scielo.br/j/ramb/a/PKwdjzFXvWWf7TFJPD4V5FB/

  Our findings suggest the hypothesis that PDE5 deregulation exerts a pathogenic role for both sickle cell disease-associated priapism and for idiopathic priapism, and that it offers a molecular target for the therapeutic management of priapism. […] These preliminary observations suggest that continuous long-term oral PDE5 inhibitor therapy may treat and prevent recurrent priapism.

• #25 :: WJMH :: World Journal of Men’s Health

  https://wjmh.org/DOIx.php?id=10.5534/wjmh.2016.34.1.1

  Priapism is defined as a persistent and painful erection lasting longer than four hours without sexual stimulation, and usually needs emergency management. […] The goal of management of priapism is to achieve detumescence of the persistent penile erection and to preserve erectile function after resolution of the priapism. […] The goal of clinical management for priapism is to make the continuous erection fade away and to preserve the ability to have erections in the future. Therefore, emergency evaluations to determine whether the priapism is ischemic or non-ischemic are required to initiate the appropriate management. […] For preventing recurrence of stuttering priapism, hormonal therapy using gonadotropin-releasing hormone agonists, estrogens, anti-androgens, and 5-reductase inhibitors has been a successful medical management option. […] Hormonal agents such as anti-androgens, 5-reductase inhibitors, and gonadotropin-releasing hormone agonists have been suggested as additional options for conservative treatment of some patients.

• #26 Advances in the understanding of priapism – Hudnall – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/14428/html

  Priapism, a persistent penile erection lasting longer than 4 hours and unrelated to sexual activity, is one of the most common emergencies treated by urologists. […] Though advances in both basic and clinical research continue and effective treatment options are available, methods for the prevention of priapism continue to be elusive. […] It is recommended that treatment be initiated with aspiration and injection of a diluted alpha-adrenergic agent. […] Perioperative anticoagulation should be initiated immediately after identifying the need for a surgical shunt procedure and continued into the post-operative period. Timely anticoagulation will minimize shunt failure and maximize treatment success. […] Current treatment options that we recommend include treatment with antiandrogens, such as bicalutamide or ketoconazole, or GnRH agonists for 34 months.

• #27 Using cyproterone acetate to treat recurrent ischemic priapism in a patient with sickle cell anemia as a comorbidity: a case report | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-020-02527-1

  Priapism cases represent a significant challenge in therapeutic management because of the elevated risk of structural damage to the penis. […] This patients case demonstrates that cyproterone acetate prescription is a great preventative strategy that limits priapism recurrences. […] The goal of managing recurrent ischemic priapism is to prevent future episodes. Success of therapies is defined by reduced recurrence of the condition and no side effects such as loss of libido, erectile dysfunction, gynecomastia, and hot flashes. […] The European Urological Association and the American Urological Association guidelines recognize the role that preventive measures in the management of ischemic priapism have in preventing fibrotic transformation of corpora cavernosa and erectile dysfunction. […] This case demonstrates that cyproterone acetate prescription is a great preventative strategy that limits ischemic priapism recurrence among patients with SCD as a comorbidity.

• #28 Priapism Treatment & Management: Approach Considerations, Prehospital Care, Low-Flow Priapism

  https://emedicine.medscape.com/article/437237-treatment

  Priapism in females is extremely rare but has been described. […] Early consultation with a urologist is recommended, especially when less-invasive measures in the ED fail to resolve priapism or a high-flow condition is suspected. […] Some patients may have recurrent priapism, which is challenging to prevent/treat. […] These patients may be prescribed a home supply of terbutaline. […] Patients with sickle cell disease may also benefit from intramuscular leuprolide injections prescribed by a urologist. […] Finasteride proved effective for preventing recurrent priapism in a study of 5 adolescents and children with sickle cell disease; most of these patients responded to a dosage of 1 mg a day.

• #29 Differences in polysomnographic, nocturnal penile tumescence and penile doppler ultrasound findings in men with stuttering priapism and sleep-related painful erections | International Journal of Impotence Research

  https://www.nature.com/articles/s41443-021-00462-3

  Men with Stuttering Priapism (SP) and sleep-related painful erections (SRPE) experience bothersome nocturnal painful erections resulting in poor sleep. […] The goal in the management of men with both conditions is symptomatic relief by reducing the frequency and duration of episodes; improving the pain experienced and improving the patients sleep. Prevention of episodes of prolonged IP with the associated morbidity is a further key goal on the management of men with SP. […] Based on the differences identified in this study, it is likely that SP and SRPE have a different underlying pathophysiology. […] Multiple treatment options are available for SP, including PDE5i, -agonists or androgen deprivation therapy (ADT). Treatment options for SP aim to prevent or suppress painful nocturnal erections. […] In men with SRPE, the primary aim is improvement in symptoms, therefore potential benefits of any treatment must be weighed up against the side effects.

• #30 Priapism – Knowledge and References – Taylor & Francis

  https://taylorandfrancis.com/knowledge/Medicine_and_healthcare/Sexual_%26_reproductive_health/Priapism/

  Other areas of interest to consider in the management of priapism could include any genetic components that may predispose patients to priapism or to recurrent ischemic priapism. […] This sole study indicates that if we could identify patients more likely to develop priapism, we could potentially prevent future episodes of the disease state via prophylactic therapeutics and therefore the sequalae of associated side effects. […] Chronic priapism represents a challenging therapeutic dilemma. Inadequate or deferred treatment can result in impaired quality of life, and permanent erectile dysfunction. […] The most commonly used one in SCI is oral baclofen. Intrathecal baclofen can also be used when the oral form fails. Baclofen is a Gamma Aminobutyric Acid (GABA) agonist which can inhibit erection and ejaculation through GABA activity.

• #31 Priapism – MD Searchlight

  https://mdsearchlight.com/mens-health/priapism/

  Regular check-ups are really important to make sure the treatment is working as it should. Patients who have a chance of their condition returning might be given one or more medications that have been found to help keep it under control. The medications used most often include bicalutamide, finasteride, sildenafil, baclofen, gabapentin, hydroxyurea (but only for patients with a blood disorder called sickle cell), phenylephrine, pseudoephedrine, and IM leuprolide. Doctors will decide whether these should be given alone or in combination, based on the individual patients needs. […] Its important to note that the longer the condition persists before receiving medical intervention, the more damage it can cause. Therefore, if you experience an erection lasting four hours or longer, you should seek immediate medical attention.

• #32 Priapism (painful erections)

  https://www.nhs.uk/conditions/priapism-painful-erections/

  Priapism is a long-lasting painful erection. It can cause permanent damage to your penis if not treated quickly. […] An erection that lasts this long needs to be treated in hospital as soon as possible to avoid permanent damage to the penis. […] Treatments to help reduce your erection include: using a needle to drain blood from your penis, which is done while the area is numbed under local anaesthetic.

• #33 Priapism (permanent erection) – USZ

  https://www.usz.ch/en/disease/priapism/

  Priapism is a painful permanent erection of the penis that is a serious emergency. Doctors must treat permanent erectile dysfunction immediately, otherwise, in the worst case, there is a risk of permanent erectile dysfunction. […] A permanent erection is a medical emergency that must be treated immediately by a doctor. Without prompt treatment, the tissue can die off due to the reduced blood supply, leading to the risk of erectile dysfunction. You must therefore seek medical treatment immediately. […] No special measures to prevent priapism are known. It is important that you visit us immediately if you have a permanent erection that lasts longer than two hours and seek treatment. Do not wait too long out of shame, otherwise the tissue may die and there is a risk of erectile dysfunction.

• #34 Priapism Emergency Treatment: Ischemic, Non-ischemic, Recurrent

  https://www.ebmedicine.net/topics/hepatic-renal-genitourinary/priapism-emergency

  Definitive therapy for priapism means inserting a needle into the corpus cavernosum. […] You can supplement your management of ischemic priapism with fluids and oxygen, but these therapies should neither delay nor take the place of aspiration and penile injection. […] Patients who present after 36 hours of priapism should have immediate urologic consultation for consideration of placement of a penile prosthesis even if detumescence is achieved in the ED. […] Taking the time to properly anesthetize the penis (preferably using ultrasound guidance) before aspiration will save the patient pain and discomfort later, especially if another aspiration approach or surgical shunt is required. […] Burnett AL, Bivalacqua TJ, Champion HC, et al. Feasibility of the use of phosphodiesterase type 5 inhibitors in a pharmacologic prevention program for recurrent priapism. […] Burnett AL, Anele UA, Trueheart IN, et al. Randomized controlled trial of sildenafil for preventing recurrent ischemic priapism in sickle cell disease. […] Hoeh MP, Levine LA. Prevention of recurrent ischemic priapism with ketoconazole: evolution of a treatment protocol and patient outcomes.

• #35 Complications of SCD: Priapism (Painful Erection of the Penis) | Sickle Cell Disease (SCD) | CDC

  https://www.cdc.gov/sickle-cell/complications/priapism.html

  Sickled red blood cells in the penis can cause a persistent and often painful erection of the penis, known as priapism. Priapism can be considered major, with episodes lasting four hours or more, or stuttering, with recurrent episodes lasting a few minutes to up to three hours. […] Episodes lasting four hours or more are associated with a greater risk of permanent tissue damage so its important to seek medical care immediately.

• #36 Priapism: The ED-Focused Approach — NUEM Blog

  https://www.nuemblog.com/blog/priapism

  Once the diagnosis of ischemic priapism has been made, intervention is required to prevent long term dysfunction. Underlying conditions such as sickle cell should be considered and treated as appropriate (hydration, O2 etc), but they should not delay treatment of priapism. […] Ischemic priapism will usually present with a painful, tender and a fully rigid phallus. Non-ischemic is usually less rigid and less painful. […] Both the European and American Urological Associations recommend cavernosal aspiration and intracavernosal sympathomimetic injection as the treatment of choice. […] If these methods fail, urgent urological consultation is required for possible placement of a corpus cavernosum-spongiosum shunt. […] For patients with a positive history of sickle cell disease, ischemic priapism is managed in the same way it is when caused by other etiologies. In addition, narcotic analgesia, IV hydration, supplemental oxygen, and alkalization is indicated.

• #37 FDA Drug Safety Communication: FDA warns of rare risk of long-lasting erections in males taking methylphenidate ADHD medications and has approved label changes | FDA

  https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-warns-rare-risk-long-lasting-erections-males-taking

  The U.S. Food and Drug Administration (FDA) is warning that methylphenidate products, one type of stimulant drug used to treat attention deficit hyperactivity disorder (ADHD), may in rare instances cause prolonged and sometimes painful erections known as priapism. […] Patients who take methylphenidate and develop erections lasting longer than four hours should seek immediate medical treatment to prevent long-term problems with the penis. […] Priapism can occur in males of any age and happens when blood in the penis becomes trapped, leading to an abnormally long-lasting and sometimes painful erection. […] All male patients and their caregivers should be taught the signs and symptoms of priapism and the importance of seeking immediate medical treatment if it occurs. […] Methylphenidate products may rarely cause priapism long-lasting and sometimes painful erections in males of any age. If not treated right away, priapism can lead to permanent damage to the penis.

• #38 Understanding Priapism: Diabetes-Related Symptoms and Risk Factors

  https://tap.health/priapism-diabetes-risks/

  Priapism, a persistent and painful erection lasting more than four hours, can be a serious complication, particularly for men with diabetes. […] For individuals with diabetes, strict blood sugar control is crucial in reducing the risk. […] Effective diabetes management is paramount in mitigating the risk of priapism. Maintaining healthy blood sugar levels through proper diet, regular exercise, and medication, as prescribed by your doctor, is crucial. […] Maintaining optimal blood sugar levels through a balanced diet, regular exercise, and adherence to prescribed medications is key to prevention. […] Seek immediate medical attention if you experience a persistent erection lasting more than four hours. […] Priapism is a medical emergency that requires immediate attention. Delaying treatment can lead to permanent erectile dysfunction. If you experience a persistent erection lasting more than four hours, seek immediate medical assistance from a qualified healthcare professional. […] Early intervention is key to minimizing long-term complications.

• #39 Priapism Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/priapism.html

  Priapism is an abnormally prolonged and often painful erection. This erection may not be related to sexual desire or stimulation. It often won’t be relieved by orgasm. […] In a few cases, priapism can occur more than once. If this happens, it is important to avoid medications, alcohol or drugs that may trigger these episodes. However, in most men, priapism occurs unexpectedly and cannot be prevented. […] You should call a physician if you develop an erection that lasts longer than four to six hours, particularly if this erection is painful and is not caused by sexual stimulation.

• #40 Priapism — iManage

  https://www.scdguide.org/priapism

  Priapism is a condition where the penis stays erect (hard) for a long time. This can be painful. It happens when blood is not able to leave the penis. It is not because of sexual arousal. […] Priapism that happens frequently or that lasts a long time can affect your ability to have an erection for sex. It may also make it hard to have children. […] The goal of treatment is to limit pain and prevent long-term effects. If the erection lasts longer than 4 hours, your provider may give you fluids and pain medicines, either by mouth or through your veins. […] If your priapism lasts longer than 2 hours, call your health care provider. You may need to go to the emergency room. […] If your priapism occurs frequently or is severe and not getting better, you should have these specially trained providers as part of your health care team: A hematologist (trained to treat blood diseases such as sickle cell) […] A urologist (trained to treat conditions of the urinary tract and male reproductive system).

• #41 Painful Erections: What You Need to Know: Urology Associates Medical Group: Urologists

  https://www.urologymedicalgroup.com/blog/painful-erections-what-you-need-to-know

  Several different conditions can cause painful erections, such as certain medicines, trauma, infection, or hormone deficiencies. […] Experiencing pain during an erection is never normal and you should always follow up with a medical evaluation. […] Painful erections, or priapism, are never normal. […] If you’re experiencing painful erections, schedule an exam with a urologist. With Peyronies disease, early intervention can prevent complications from developing, so if you notice any of the signs, see Dr. Weintraub as soon as possible. […] That being said, early intervention can prevent additional scar tissue from forming and reduce your pain.

• #42 Priapism – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/priapism/diagnosis-treatment/drc-20352010

  If you have an erection lasting more than four hours, you need emergency care. […] Treatment might be needed to prevent further episodes. […] What can be done to prevent this problem in the future?

• #43 Advances in the understanding of priapism – Hudnall – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/14428/html

  In patients who present with recurrent priapism, androgen ablation therapy is an effective and proven therapy. […] Early penile prosthesis implantation has also been advocated for patients with an ischemic episode lasting greater than 48 hours before intervention. […] Non-invasive medical therapy with androgen ablation can provide an effective alternative to the above invasive procedures. […] As the mechanisms underpinning recurrent ischemic priapism become clearer, additional opportunities for pharmacologic intervention and management will arise. […] The primary goal of pharmacologic management of recurrent ischemic priapism is to prevent additional episodes that increase the risk of progression to a major ischemic priapism event. […] The most common pharmacologic therapies for stuttering priapism involve hormone regulation, and more recently, PDE5 inhibitors. […] Prevention of additional ischemic episodes remains the goal of therapy, and larger clinical trials will provide a more comprehensive evidence base from which stronger conclusions and recommendations can be drawn.

• #44 ANNUAL MEETING GUIDELINE PRESENTATION Non-Ischemic and Recurrent Priapism: An AUA/Sexual Medicine Society of North America Guideline – American Urological Association

  https://auanews.net/issues/articles/2022/may-2022/annual-meeting-guideline-presentation-non-ischemic-and-recurrent-priapism-an-aua/sexual-medicine-society-of-north-america-guideline

  Priapism is a condition resulting in a prolonged and uncontrolled erection. […] Acute ischemic priapism is an emergency. As the natural history of untreated acute ischemic priapism includes days to weeks of painful erections followed by permanent loss of erectile function, the condition requires prompt evaluation and may require emergency management. […] Thus, all patients with priapism should be evaluated emergently to identify the subtype of priapism (acute ischemic priapism versus NIP) and those with an acute ischemic event provided early intervention when indicated. […] Management of this condition not only requires treatment of acute episodes, but also focuses on future prevention and mitigation of an acute ischemic event necessitating surgical management. In this Guideline, we have summarized the major advances using oral pharmacological and endocrine modulating agents to prevent recurrent ischemic priapism. […] The 2021 Guideline on Acute Ischemic Priapism, which was developed by the AUA in collaboration with the Sexual Medicine Society of North America, includes greater detail on the roles of pharmacological agents to prevent recurrent ischemic priapism.

Zobacz więcej