Evaluation and management of priapism: 2009 update

Nature Reviews Urology

Volumn 6, Issue 5, 2009, Pages 262-271

  Huang, Yun Ching ^a   Harraz, Ahmed M ^a   Shindel, Alan W ^a   Lue, Tom F ^a  

^a UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADRENALIN; ADRENERGIC RECEPTOR STIMULATING AGENT; ANALGESIC AGENT; EPHEDRINE; METARAMINOL; METHYLENE BLUE; NORADRENALIN; OXYGEN; PHENYLEPHRINE; PHOSPHODIESTERASE V INHIBITOR; PLACEBO; PSEUDOEPHEDRINE; TERBUTALINE; THROMBIN;

ANAMNESIS; ARTIFICIAL EMBOLISM; ASPIRATION; CLINICAL TRIAL; COMPUTER ASSISTED TOMOGRAPHY; CONSERVATIVE TREATMENT; CRYOTHERAPY; DIAGNOSTIC VALUE; DRUG CHOICE; DRUG EFFICACY; DRUG MECHANISM; DRUG SAFETY; ECHOGRAPHY; ERECTILE DYSFUNCTION; EXCHANGE BLOOD TRANSFUSION; FLUID THERAPY; HUMAN; INCIDENCE; LABORATORY TEST; LOW DRUG DOSE; MAGNETIC RESONANCE ANGIOGRAPHY; NONHUMAN; OXYGEN THERAPY; PATHOPHYSIOLOGY; PENIS ERECTION; PHYSICAL EXAMINATION; POSTOPERATIVE CARE; PRIAPISM; PRIORITY JOURNAL; REVIEW; RISK FACTOR; SHUNTING; SICKLE CELL ANEMIA; SURGICAL TECHNIQUE; ARTERIOVENOUS SHUNT; COLOR ULTRASOUND FLOWMETRY; DISEASE MANAGEMENT; MALE; METHODOLOGY;

ARTERIOVENOUS SHUNT, SURGICAL; DISEASE MANAGEMENT; ERECTILE DYSFUNCTION; HUMANS; MALE; PRIAPISM; ULTRASONOGRAPHY, DOPPLER, COLOR;

EID: 77449089806     PISSN: 17594812     EISSN: 17594820     Source Type: Journal    
DOI: 10.1038/nrurol.2009.50     Document Type: Review

References (123)

1. Papadopoulos, i.&Kelami, A. Priapus and priapism from mythology to medicine. Urology 32, 385-386 (1988).
2. Hinman, F. Priapism. Ann. Surg. 60, 689-716 (1914).
3. Montague, D. K. et al. American Urological Association guideline on the management of priapism. J. Urol. 70, 1318-1324 (2003).
4. eland, i. A., van der Lei, J., stricker, B. H.&sturkenboom, M. J. incidence of priapism in the general population. Urology 57, 970-972 (2001).
5. earle, C. M., stuckey, B. G., Ching, H. L.&wisniewski, Z. s. The incidence and management of priapism in western Australia: a 16 year audit. Int. J. Impot. Res. 15, 272-276 (2003).
6. Emond, A. M., Holman, R., Hayes, R. J.&serjeant, G. R. Priapism and impotence in homozygous sickle cell disease. Arch. Intern. Med. 140, 1434-1437 (1980).
7. Mantadakis, E., Cavender, J. D., Rogers, Z. R., Ewalt, D. H.&Buchanan, G. R. Prevalence of priapism in children and adolescents with sickle cell anemia. J. Pediatr. Hematol. Oncol. 21, 518-522 (1999).
8. Bennett, N.&Mulhall, J. sickle cell disease status and outcomes of African-American men presenting with priapism. J. Sex. Med. 5, 1244-1250 (2008).
9. Brant, W. O. et al. Priapism: etiology, diagnosis and management. AUA Update Series 25, 99-107 (2006).
10. Quigley, M.&Fawcett, D. P. Thrombophilia and priapism. BJU Int. 83, 155 (1999).
11. Thuret, I. et al. Priapism following splenectomy in an unstable hemoglobin: hemoglobin Olmsted beta 141 (H19) LeuRArg. Am. J. Hematol. 51, 133-136 (1996).
12. Morano, S. G. et al. Treatment of long-lasting priapism in chronic myeloid leukemia at onset. Ann. Hematol. 79, 644-645 (2000).
13. Rosenbaum, E. H., Thompson, H. E.&Glassberg, A. B. Priapism and multiple myeloma. successful treatment with plasmapheresis. Urology 12, 201-202 (1978).
14. Nelson, J. H.&winter, C. C. Priapism: evolution of management in 48 patients in a 22-year series. J. Urol. 117, 455-458 (1977).
15. Hébuterne, X., Frere, A. M., Bayle, J.&rampal, P. Priapism in a patient treated with total parenteral nutrition. JPEN J. Parenter. Enteral Nutr. 16, 171-174 (1992).
16. Singhal, P. C., Lynn, R. I.&scharschmidt, L. A. Priapism and dialysis. Am. J. Nephrol. 6, 358-361 (1986).
17. Finley, D. S. Glucose-6-phosphate dehydrogenase deficiency associated stuttering priapism: report of a case. J. Sex. Med. 5, 2963-2966 (2008).
18. Chan, P. T. et al. Priapism secondary to penile metastasis: A report of two cases and a review of the literature. J. Surg. Oncol. 68, 51-59 (1998).
19. Hettiarachchi, J. A. et al. Malignant priapism associated with metastatic urethral carcinoma. Urol. Int. 66, 114-116 (2001).
20. Cherrie, r. J.&Brosman, s. A. Case profile: priapism secondary to metastatic adenocarcinoma of rectum. Urology 25, 655 (1985).
21. Nezu, F. M. et al. Malignant priapism as the initial clinical manifestation of metastatic renal cell carcinoma with invasion of both corpora cavernosum and spongiosum. Int. J. Impot. Res. 10, 101 (1998).
22. Kvarstein, B. Bladder cancer complicated with priapism. A case report. Scand. J. Urol. Nephrol. Suppl. 179, 155-156 (1996).
23. Schroeder-Printzen, I., Vosshenrich, R., Weidner, W.&Ringert, R. H. Malignant priapism in a patient with metastatic prostate adenocarcinoma. Urol. Int. 52, 52-54 (1994).
24. Gallagher, J. P. A lesson in neurology from the hangman. JSC Med. Assoc. 91, 38 (1995).
25. Greschner, M., Krautschick, A.&Alken, P. Highflow priapism leading to the diagnosis of lung cancer. Urol. Int. 60, 126-127 (1998).
26. Hopkins, A., Clarke, C.&Brindley, G. erections on walking as a symptom of spinal canal stenosis. J. Neurol. Neurosurg. Psychiatry 50, 1371-1374 (1987).
27. Munro, D., Horne, H. W. Jr. &Paull, D. P. The effect of injury to the spinal cord and cauda equina on the sexual potency of men. N. Engl. J. Med. 239, 903-911 (1948).
28. ravindran, M. Cauda equina compression presenting as spontaneous priapism. J. Neurol. Neurosurg. Psychiatry 42, 280-282 (1979).
29. Dittrich, A., Albrecht, K., Bar-Moshe, O.&Van Den Dris, M. Treatment of pharmacological priapism with phenylephrine. J. Urol. 146, 323-324 (1991).
30. ruan, X. et al. Priapism-a rare complication following continuous epidural morphine and bupivacaine infusion. Pain Physician 10, 707-711 (2007).
31. Burnett, A. L. Pathophysiology of priapism: Dysregulatory erection physiology thesis. J. Urol. 170, 26-34 (2003).
32. ilkay, A. K.&Levine, L. A. Conservative management of high-flow priapism. Urology 46, 419-424 (1995).
33. Burt, F. B., schirmer, H. K.&scott, w. w. A new concept in the management of priapism. J. Urol. 83, 60-61 (1960).
34. Witt, M. A., Goldstein, I., Saenz De Tejada, I., Greenfield, A.&Krane, R. J. Traumatic laceration of intracavernosal arteries: The pathophysiology of nonischemic, high flow, arterial priapism. J. Urol. 143, 129-132 (1990).
35. Towbin, R. et al. Priapism in children: treatment with embolotherapy. Pediatr. Radiol. 37, 483-487 (2007).
36. Kim, s. H.&Kim, s. H. Post-traumatic erectile dysfunction: Doppler Us findings. Abdom. Imaging 12, 1-9 (2006).
37. McMahon, C. G. High flow priapism due to an arterial-lacunar fistula complicating initial venoocclusive priapism. Int. J. Impot. Res. 14, 195-196 (2002).
38. Rodríguez, J., Cuadrado, J. M., Frances, A.&Franco, E. High-flow priapism as a complication of a veno-occlusive priapism: two case reports. Int. J. Impot. Res. 18, 215-217 (2006).
39. Bertolotto, M., Ciampalini, S., Martingano, P.&Mucelli, F. P. High-flow priapism complicating ischemic priapism following iatrogenic laceration of the dorsal artery during a winter procedure. J. Clin. Ultrasound 37, 61-64 (2008).
40. Tuygun, C., Guvercinci, M., Conkbayir, I., Gucuk, A.&imamoglu, A. Post-surgical highflow priapism treated by embolization. Int. J. Urol. 14, 1107-1108 (2007).
41. Liguori, G. et al. High-flow priapism (HFP) secondary to Nesbit operation: management by percutaneous embolization and colour Dopplerguided compression. Int. J. Impot. Res. 17, 304-306 (2005).
42. Wolf, J. S. Jr&Lue, T. F. High-flow priapism and glans hypervascularization following deep dorsal vein arterialization for vasculogenic impotence. Urol. Int. 49, 227-229 (1992).
43. Kim, K. R. et al. Treatment of high-flow priapism with superselective transcatheter embolization in 27 patients: a multicenter study. J. Vasc. Interv. Radiol. 18, 1222-1226 (2007).
44. Arrigo, T., Crisafulli, G., salzano, G., Zirilli, G.&De Luca, F. High-flow priapism in testosteronetreated boys with constitutional delay of growth and puberty may occur even when very low doses are used. J. Endocrinol. Invest. 28, 390-391 (2005).
45. Ramos, C. E., Park, J. S., Ritchey, M. L.&Benson, G. S. High flow priapism associated with sickle cell disease. J. Urol. 153, 1619-1621 (1995).
46. Poey, C. et al. Non traumatic high flow priapism: arterial embolization treatment [French]. J. Radiol. 87, 115-119 (2006).
47. Mentzel, H. J. et al. High-flow priapism in acute lymphatic leukaemia. Pediatr. Radiol. 34, 560-563 (2004).
48. Foda, M. M. et al. High-flow priapism associated with Fabry's disease in a child: a case report and review of the literature. Urology 48, 949-952 (1996).
49. Dubocq, F. M., Tefilli, M. v., Grignon, D. J., Pontes, J. e.&Dhabuwala, C. B. High flow malignant priapism with isolated metastasis to the corpora cavernosa. Urology 51, 324-326 (1998).
50. el-Assmy, A., Hekal, i. A.&Abou-el-Ghar, M. e. Use of magnetic resonance angiography in diagnosis and decision making of posttraumatic, high-flow priapism. Scientific World Journal 19, 176-181 (2008).
51. Suzuki, K. et al. Post-traumatic high flow priapism: demonstrable findings of penile enhanced computed tomography. Int. J. Urol. 8, 648-651 (2001).
52. Hakim, L. S., Kulaksizoglu, H., Mulligan, R., Greenfield, A.&Goldstein, I. evolving concepts in the diagnosis and treatment of arterial high flow priapism. J. Urol. 155, 541-548 (1996).
53. wear, J. B. A new approach to the treatment of priapism. J. Urol. 117, 252-254 (1977).
54. Merritt, A. L., Haiman, C.&Henderson, s. O. Myth: blood transfusion is effective for sickle cell anemia-associated priapism. CJEM 8, 119-122 (2006).
55. Lowe, F. C.&Jarow, J. P. Placebo-controlled study of oral terbutaline and pseudoephedrine in management of prostaglandin e1-induced prolonged erections. Urology 42, 51-53 (1993).
56. Pryor, J. et al. Priapism. J. Sex. Med. 1, 116-120 (2004).
57. Maan, Z., Arya, M.&Patel, H. r. Priapism-a review of the medical management. Expert Opin. Pharmacother. 4, 2271-2277 (2003).
58. Muruve, N.&Hosking, D. H. intracorporeal phenylephrine in the treatment of priapism. J. Urol. 155, 141-143 (1996).
59. Kulmala, R. V.&Tamella, T. L. effects of priapism lasting 24 hours or longer caused by intracavernosal injection of vasoactive drugs. Int. J. Impot. Res. 7, 131-136 (1995).
60. Broderick, G. A.&Harkaway, r. Pharmacologic erection: time-dependent changes in the corporal environment. Int. J. Impot. Res. 6, 9-16 (1994).
61. Kilinc, M. Temporary cavernosal-cephalic vein shunt in low-flow priapism treatment. Eur. Urol. doi:10.1016/j.eururo.2008.10.009 (2008).
62. Garcia, M. M., shindel, A. w.&Lue, T. F. T-shunt with or without tunnelling for prolonged ischaemic priapism. BJU Int. 102, 1754-1764 (2008).
63. Brant, W. O., Garcia, M. M., Bella, A. J., Chi, T.&Lue, T. F. T-shaped shunt and intracavernous tunneling for prolonged ischemic priapism. J. Urol. 181, 1699-1705 (2009).
64. Burnett, A. L.&Pierorazio, P. M. Corporal "snake" maneuver. Corporoglanular shunt surgical modification for ischemic priapism. J. Sex. Med. doi:10.1111/ j.1743-61092008.01176.x (2009).
65. Bochinski, D. J., Deng, D. Y.&Lue, T. F. The treatment of priapism: when and how? Int. J. Impot. Res. 15, s86-s90 (2003).
66. Ralph, D. J. et al. The immediate insertion of a penile prosthesis for acute ischaemic priapism. Eur. Urol. doi:10.1016/j. eururo.2008.09.044 (2008).
67. Rees, R. W. et al. The management of low-flow priapism with immediate insertion of a penile prosthesis. BJU Int. 90, 893-897 (2002).
68. steinberg, J.&eyre, r. C. Management of recurrent priapism with epinephrine selfinjection and gonadotropin-releasing hormone analogue. J. Urol. 153, 152-153 (1995).
69. Dahm, P., Rao, D. S.&Donatucci, C. F. Antiandrogens in the treatment of priapism. Urology 59, 138 (2002).
70. Saad, S. T. et al. Follow-up of sickle cell disease patients with priapism treated by hydroxyurea. Am. J. Hematol. 77, 45-49 (2004).
71. Perimenis, P., Athanasopoulos, A., Papathanasopoulos, P.&Barbalias, G. Gabapentin in the management of the recurrent, refractory, idiopathic priapism. Int. J. Impot. Res. 16, 84-85 (2004).
72. Hübler, J., Szántó, A.&Könyves, K. Methylene blue as a means of treatment for priapism caused by intracavernous injection to combat erectile dysfunction. Int. Urol. Nephrol. 35, 519-521 (2003).
73. rourke, K. F., Fischler, A. H.&Jordan, G. H. Treatment of recurrent idiopathic priapism with oral baclofen. J. Urol. 168, 2552-2553 (2002).
74. Gupta, S. et al. A possible mechanism for alteration of human erectile function by digoxin: inhibition of corpus cavernosum sodium/potassium adenosine triphosphatase activity. J. Urol. 159, 1529-1536 (1998).
75. Perimenis, P., Athanasopoulos, A., Geramoutsos, i.&Barbalias, G. The incidence of pharmacologically induced priapism in the diagnostic and therapeutic management of 685 men with erectile dysfunction. Urol. Int. 66, 27-29 (2001).
76. Muneer, A., Minhas, S., Arya, M.&ralph, D. J. stuttering priapism-a review of the therapeutic options. Int. J. Clin. Pract. 62, 1265-1270 (2008).
77. Shamloul, R.&EL Nashaar, A. idiopathic stuttering priapism treated successfully with low-dose ethinyl estradiol: a single case report. J. Sex. Med. 2, 732-734 (2005).
78. Kumar, R., Shrivastava, D. N.&Seth, A. spontaneous resolution of delayed onset, posttraumatic high-flow priapism. J. Postgrad. Med. 52, 298-299 (2006).
79. Ciampalini, s. et al. High-flow priapism: treatment and long-term follow-up. Urology 59, 110-113 (2002).
80. Hatzichristou, D. et al. Management strategy for arterial priapism: therapeutic dilemmas. J. Urol. 168, 2074-2077 (2002).
81. Cakan, M., Altu Gcaron, U.&Aldemir, M. is the combination of superselective transcatheter autologous clot embolization and duplex sonography-guided compression therapy useful treatment option for the patients with high-flow priapism? Int. J. Impot. Res. 18, 141-145 (2006).
82. Liu, B. X. et al. High-flow priapism: superselective cavernous artery embolization with microcoils. Urology 72, 571-573 (2008).
83. Lloret, F., Martinez-Cuesta, A., Domínguez, P., Noguera, J. J.&Bilbao, J. i. Arterial microcoil embolization in high flow priapism [spanish]. Radiologia 50, 163-167 (2008).
84. Chung, E., McKnight, J.&Hosken, B. Post traumatic prepubertal high-flow priapism: a rare occurrence. Pediatr. Surg. Int. 24, 379-381 (2008).
85. Numan, F. et al. Post-traumatic high-flow priapism treated by N-butyl-cyanoacrylate embolisation. Cardiovasc. Intervent. Radiol. 19, 278-280 (1996).
86. Hanada, E. et al. Case report of posttraumatic arterial high-flow priapism [Japanese]. Hinyokika Kiyo 54, 633-635 (2008).
87. Numan, F. et al. Post-traumatic nonischemic priapism treated with autologous blood clot embolization. J. Sex. Med. 5, 173-179 (2008).
88. Hellstrom, W. J., Derosa, A.&Lang, E. The use of transcatheter superselective embolization to treat high flow priapism (arteriocavernosal fistula) caused by straddle injury. J. Urol. 178, 1059 (2007).
89. Bertolotto, M., Zappetti, R., Pizzolato, R.&Liguori, G. Color Doppler appearance of penile cavernosal-spongiosal communications in patients with high-flow priapism. Acta Radiol. 49, 710-714 (2008).
90. Volgger, H., Pfefferkorn, S.&Hobisch, A. Posttraumatic high-flow priapism in children: noninvasive treatment by color Doppler ultrasound-guided perineal compression. Urology 70, 590.e3-590.e5 (2007).
91. Resim, S., Sahinkanat, T.&Karabiber, H. Highflow priapism of unknown etiology in a prepubertal boy. Pediatr. Int. 46, 492-493 (2004).
92. Volkmer, B. G. et al. High-flow priapism: a combined interventional approach with angiography and colour Doppler. Ultrasound Med. Biol. 28, 165-169 (2002).
93. Bartsch, G. Jr, Kuefer, r., engel, O.&volkmer, B. G. High-flow priapism: colour-Doppler ultrasound-guided supraselective embolization therapy. World J. Urol. 22, 368-370 (2004).
94. O'sullivan, P., Browne, r., Mceniff, N.&Lee, M. J. Treatment of "high-flow" priapism with superselective transcatheter embolization: a useful alternative to surgery. Cardiovasc. Intervent. Radiol. 29, 198-201 (2006).
95. Kim, K. r. et al. Treatment of high-flow priapism with superselective transcatheter embolization in 27 patients: a multicenter study. J. Vasc. Interv. Radiol. 18, 1222-1226 (2007).
96. savoca, G. et al. sexual function after highly selective embolization of cavernous artery in patients with high flow priapism: long-term followup. J. Urol. 172, 644-647 (2004).
97. sandock, D. s., seftel, A. D., Herbener, T. e., Goldstein, i.&Greenfield, A. J. Perineal abscess after embolization for high-flow priapism. Urology 48, 308-311 (1996).
98. Martínez Portillo, F. J., Fernández Arancibia, M. i., Bach, s., Alken, P.&Jünemann, K. P. Methylene blue: an effective therapeutic alternative for priapism induced by intracavernous injection of vasoactive agents [spanish]. Arch. Esp. Urol. 55, 303-308 (2002).
99. imamoglu, A., Bakírtas, H., Conkbayír, i., Tuygun, C.&sarící, H. An alternative noninvasive approach for the treatment of highflow priapism in a child: duplex ultrasoundguided compression. J. Pediatr. Surg. 41, 446-448 (2006).
100. sancak, T.&Conkbayir, i. Post-traumatic highflow priapism: management by superselective transcatheter autologous clot embolization and duplex sonography-guided compression. J. Clin. Ultrasound 29, 349-353 (2001).
101. Kiss, A. et al. Treatment of post-traumatic highflow priapism in 8-year-old boy with percutaneous ultrasound-guided thrombin injection. Urology 69, 779.e7-9 (2007).
102. shapiro, r. H.&Berger, r. e. Post-traumatic priapism treated with selective cavernosal artery ligation. Urology 49, 638-643 (1997).
103. Champion, H. C., Bivalacqua, T. J., Takimoto, e., Kass, D. A.&Burnett, A. L. Phosphodiesterase-5A dysregulation in penile erectile tissue is a mechanism of priapism. Proc. Natl Acad. Sci. USA 102, 1661-1666 (2005).
104. Lin, G., Xin, Z. C., Lue, T. F.&Lin, C. s. Up and down-regulation of phosphodiesterase-5 as related to tachyphylaxis and priapism. J. Urol. 2, s15-s18 (2003).
105. Burnett, A. L., Bivalacqua, T. J., Champion, H. C.&Musicki, B. Feasibility of the use of phosphodiesterase type 5 inhibitors in a pharmacologic prevention program for recurrent priapism. J. Sex. Med. 3, 1077-1084 (2006).
106. Lue, T. F. Priapism after transurethral alprostadil. J. Urol. 161, 725-726 (1999).
107. wills, B. K., Albinson, C., wahl, M.&Clifton, J. sildenafil citrate ingestion and prolonged priapism and tachycardia in a pediatric patient. Clin. Toxicol. 45, 798-800 (2007).
108. King, s. H., Hallock, M., strote, J.&wessells, H. Tadalafil-associated priapism. Urology 66, 432 (2005).
109. rubin, s. O. Priapism as a probable sequel to medication. Scand. J. Urol. Nephrol. 2, 81-85 (1968).
110. siegel, s., streem, s. B.&steinmuller, D. r. Prazosin-induced priapism. Pathogenic and therapeutic implications. Br. J. Urol. 61, 165 (1988).
111. sadeghi-Nejad, H.&Jackson, i. New-onset priapism associated with ingestion of terazosin in an otherwise healthy man. J. Sex. Med. 4, 1766-1768 (2007).
112. Avisrror, M. U. et al. Doxazosin and priapism. J. Urol. 163, 238 (2000).
113. Pahuja, A., Bashir, J., williamson, e. M.&Barber, N. Unresolved priapism secondary to tamsulosin. Int. J. Impot. Res. 17, 293-294 (2005).
114. Qazi, H. A., Ananthakrishnan, K., Manikandan, r.&Fordham, M. v. stuttering priapism after ingestion of alfuzosin. Urology 68, 890.e5-6 (2006).
115. Compton, M. T.&Miller, A. H. Priapism associated with conventional and atypical antipsychotic medications: a review. J. Clin. Psychiatry 62, 362-366 (2001).
116. Kulmala, r., Lehtonen, T., Nieminen, P.&Tammela, T. Aetiology of priapism in 207 patients. Eur. Urol. 28, 241-245 (1995).
117. saenz de Tejada, i. et al. Pathophysiology of prolonged penile erection associated with trazodone use. J. Urol. 145, 60-64 (1991).
118. Dubin, N. N.&razack, A. H. Priapism: ecstasy related? Urology 56, 1057 (2000).
119. Lin, P. H., Bush, r. L.&Lumsden, A. B. Low molecular weight heparin induced priapism. J. Urol. 172, 263 (2004).
120. salerno, T. A., Charrette, e. J.&Morales, A. Priapism after aortic valve replacement. Can. J. Surg. 24, 202-203 (1981).
121. Harmon, J. D., Ginsberg, P. C., Nachmann, M. M., Manzarbeita, C.&Harkaway, r. C. stuttering priapism in a liver transplant patient with toxic levels of FK506. Urology 54, 366 (1999).
122. Zargooshi, J. Priapism as a complication of high dose testosterone therapy in a man with hypogonadism. J. Urol. 163, 907 (2000).
123. Teixeira, C. e. et al. Nitric oxide release from human corpus cavernosum induced by a purified scorpion toxin. Urology 63, 184-189 (2004).