Document Detail

Alternative approaches to the management of priapism.
MedLine Citation:
PMID:  9542685     Owner:  NLM     Status:  MEDLINE    
Herein we describe the use of intracavernous methylene blue (MB), a guanylate cyclase inhibitor, or internal pudendal artery embolization for the treatment of priapism. Eleven patients with priapism were treated from 1993-1996. Etiologies of priapism included PGE1/papaverine (3), trazodone (2), and sickle cell disease (1), in the other five cases the causes the cause was unknown. The average duration of priapism was 27 h for all patients (6-72 h). Five patients who failed intracavernous MB or an alpha-adrenergic agonist, underwent unilateral or bilateral pudendal artery embolization. The average duration of priapism for patients undergoing embolization was 43 h. Sixty-seven percent of the patients treated with MB responded with immediate detumescence. One-hundred percent of patients with priapism secondary to intracavernous injection therapy or trazodone responded. Of the five patients who underwent embolization, 40% achieved immediate pain relief and subsequent detumescence. The three non-responders exhibited a partial detumescence over 47-72 h. After follow-up of one year embolization available for only two patients revealed that one regained potency while the other remained impotent. These results confirmed that MB is effective for pharmacologically-induced priapism. Embolization is a less invasive option for refractory priapism, although results are less than satisfactory in men with priapism of several days duration.
J D deHoll; P A Shin; J F Angle; W D Steers
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of impotence research     Volume:  10     ISSN:  0955-9930     ISO Abbreviation:  Int. J. Impot. Res.     Publication Date:  1998 Mar 
Date Detail:
Created Date:  1998-05-26     Completed Date:  1998-05-26     Revised Date:  2006-07-03    
Medline Journal Info:
Nlm Unique ID:  9007383     Medline TA:  Int J Impot Res     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  11-4     Citation Subset:  IM    
Department of Urology, University of Virginia School of Medicine, Charlottesville 22908, USA.
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MeSH Terms
Alprostadil / adverse effects
Anemia, Sickle Cell / complications
Embolization, Therapeutic
Enzyme Inhibitors*
Guanylate Cyclase / antagonists & inhibitors*
Methylene Blue / administration & dosage,  therapeutic use*
Middle Aged
Papaverine / adverse effects
Priapism / drug therapy*,  etiology,  therapy
Trazodone / adverse effects
Vasodilator Agents / adverse effects
Reg. No./Substance:
0/Enzyme Inhibitors; 0/Vasodilator Agents; 19794-93-5/Trazodone; 58-74-2/Papaverine; 61-73-4/Methylene Blue; 745-65-3/Alprostadil; EC Cyclase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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