An uncommon problem that can present as a surgical emergency is described and the aetiology of priapism and its management is alluded to in the light of simpler surgical measures that are presently available.
Priapism is caused by an imbalance between penile blood inflow and outflow. There are two types of priapism: low-flow priapism due to venous occlusion and high-flow priapism due to uncontrolled arterial flow to the veins. High-flow priapism most frequently occurs as a result of penile trauma in which the intercavernosal artery disruption causes an arteriocavernosal fistula. It is rarely encountered in the pediatric and prepubertal population. Clinically, it manifests as a painless, prolonged erection after perineal trauma. Treatment ranges from expectant management to open surgical exploration with vessel ligation. We report the successful treatment of high-flow priapism in a 12-year-old prepubertal boy with superselective embolization.
Clozapine is effective in treatment resistant schizophrenia. Priaprism is a rare side effect of Clozapine. It is a urological emergency and can lead to permanent damage to the penis. We present two cases two cases of clozapine induced priapism. Both patients were started on Clozapine in view of treatment resistant. For the first patient, priapism was noted after 2 years on Clozapine and treated conservatively. Clozapine was rechallenged in this patient but in a lower dosage and was augmented with amisulpride. He did not develop priaprism until date. In the second case, patient developed priaprism after 7 months on clozapine and required urological intervention. He redeveloped recurrent episode of priaprism as clozapine was restarted on the previous dose. In conclusion, priaprism is not related to dosage or duration of treatment of Clozapine. Thus, a careful risk-benefit assessment need to done as there is always a risk of priapism to recur when clozapine rechallenged.
Priapism, an uncommon urological emergency, is commonly drug-induced. We present a previously unreported case of a young man with priapism probably related to Ecstasy.
Priapism is a rare clinical presentation of a patient with chronic myeloid leukaemia (CML). Herein, we present a young Nepalese man that presented to the emergency department with an acute and painful penile erection for two days. Clinically, he was pale and abdominal examination revealed hepatomegaly. Combined oncologic and initial urological intervention with carvernosal aspiration and intracavernosal phenylephrine failed to achieve detumescence. The patient underwent an emergency corporoglandular shunting eventually. In this case report, we discuss the management compared with previously reported cases.
Priapism is a urological emergency. The treatment for ischaemic priapism is usually cavernosal aspiration with or without cavernosal irrigation. Some patients may need surgical intervention -the various shunt procedures. We report a 21-year-old man with priapism secondary to chronic myeloid leukemia who needed a combined medical and surgical management. He underwent a spongiocavernosal shunt as well as cytoreductive chemotherapy to achieve complete detumescence. Therefore, cytoreductive chemotherapy is an adjunct in difficult cult to treat priapism associated with chronic myeloid leukemia.