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1.
Einstein (Sao Paulo) ; 18: eAO5070, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32321079

RESUMO

OBJECTIVE: To evaluate epidemiological aspects of priapism in patients with sickle cell disease, and these aspects impact on adult sexual function. METHODS: This was a cross-sectional study including individuals with sickle cell disease who were evaluated at a reference center for sickle cell. Participants completed a structured questionnaire about their sociodemographic characteristics and priapism events. Sexual function was assessed using validated two instruments, the Erection Hardness Score and one about the sex life satisfaction. RESULTS: Sixty-four individuals with median aged of 12 (7 to 28) years were interviewed. The prevalence of priapism was 35.9% (23/64). The earliest priapism episode occurred at 2 years of age and the latest at 42 years. The statistical projection was that 71.1% of individuals of the study would have at least one episode of priapism throughout life. Patients with episodes of priapism (10/23) had significantly worse erectile function Erection Hardness Score of 2 [1-3]; p=0.01 and were less satisfied with sexual life 3 [3-5]; p=0.02. CONCLUSION: Priapism is usually present in childhood, and severe episodes are associated with cavernous damage, impairment in the quality of the erection, and lower sexual satisfaction.


Assuntos
Anemia Falciforme/epidemiologia , Anemia Falciforme/fisiopatologia , Disfunção Erétil/epidemiologia , Disfunção Erétil/fisiopatologia , Priapismo/epidemiologia , Priapismo/fisiopatologia , Adolescente , Adulto , Fatores Etários , Brasil/epidemiologia , Criança , Estudos Transversais , Intervalo Livre de Doença , Humanos , Masculino , Ereção Peniana/fisiologia , Prevalência , Priapismo/etiologia , Qualidade de Vida , Estudos Retrospectivos , Estatísticas não Paramétricas , Inquéritos e Questionários , Adulto Jovem
2.
West Afr J Med ; 37(1): 32-39, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32030709

RESUMO

BACKGROUND: Priapism is a prolonged, painful penile erection common among males with Sickle Cell Disease (MWSCD) predisposing to erectile dysfunction (ED) when treatment is delayed. Unlike in women with sickle cell disease (SCD), there has been little attention to male reproductive health complications of SCD. OBJECTIVE: To investigate knowledge, experiences and coping mechanisms for priapism among MWSCD in Ibadan, Nigeria. METHODS: This descriptive cross-sectional study employed purposive sampling technique to select 95 consenting MWSCD attending haematology clinics in Ibadan for interview. A semi-structured, interviewer-administered questionnaire was used to collect information on knowledge, coping mechanisms, and experiences of priapism. Knowledge of priapism was measured and categorised as poor and good respectively. Psychosocial Experiences (PEs) were measured and categorised as mild, moderate and severe, while the Sexual Experiences (SEs) were recorded. Coping mechanisms for priapism were grouped into Medical, Psychosocial and Harmful coping mechanisms respectively. Data were analysed using descriptive statistics and Fishers' Exact test at p<0.05. RESULTS: Respondents' mean age was 23.6±8.8 years. Over half (55.8%) had good knowledge of priapism. Thirty-nine respondents (41.1%) had experienced priapism. Sexual Experiences reported include: total ED 10.3% and apathy for sexual intercourse 23.1%. Majority 30(76.9%) developed mild PEs especially fear of reoccurrence of priapism (56.4%) and sleeplessness (43.6%). The most used Medical Coping Mechanism (MCM) was cold shower (46.2%). There was no significant association between age and knowledge of priapism. CONCLUSION: Knowledge of priapism among respondents was good. Psychosocial therapy through appropriate health education, counseling and social support may help improve knowledge among people with SCD.


Assuntos
Adaptação Psicológica , Anemia Falciforme/complicações , Conhecimentos, Atitudes e Prática em Saúde , Priapismo/etiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Nigéria , Priapismo/psicologia , Adulto Jovem
3.
Radiol Med ; 125(3): 288-295, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31823294

RESUMO

PURPOSE: High-flow priapism is an incomplete and painless persistent erection caused by trauma. Its diagnosis is performed thanks to clinic and imaging evaluation with detection of fistula/pseudoaneurysm in the cavernous tissue. This paper aims to retrospectively assess the efficacy and safety of superselective arterial embolization in patients with high-flow priapism. MATERIALS AND METHODS: From January 2008 to March 2017, nine patients with high-flow priapism have been treated in a single center with embolization. The main etiology was trauma in eight subjects. The patients were evaluated with laboratory examinations and clinical and imaging findings (color Doppler ultrasonography and angiography). The mean follow-up time after embolization was 24 months. RESULTS: Eleven procedures were performed in nine patients: two of them required a second treatment session because of recurrence after 1-2 weeks. Embolic agents were microcoils, microparticles (300-500 µm) and Spongostan. Restoration of erectile function was monitored by clinical and color Doppler evaluation during follow-up. CONCLUSIONS: Superselective embolization should be the procedure of choice in patients affected by high-flow priapism; this technique appears to be successful in preserving erectile function. The choice of the embolic agent is crucial, and it should be tailored for each patient.


Assuntos
Embolização Terapêutica/métodos , Pênis/irrigação sanguínea , Priapismo/terapia , Adolescente , Adulto , Angiografia , Criança , Embolização Terapêutica/instrumentação , Procedimentos Endovasculares/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Ereção Peniana , Pênis/lesões , Priapismo/diagnóstico por imagem , Priapismo/etiologia , Recidiva , Fluxo Sanguíneo Regional , Retratamento , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia Doppler em Cores , Adulto Jovem
4.
Urologiia ; (5): 112-113, 2019 Dec.
Artigo em Russo | MEDLINE | ID: mdl-31808643

RESUMO

Blood disorders, in particular chronic myeloid leukemia (CML), are among the rare etiological factors of priapism. A clinical observation of ischemic priapism lasting 18 hours, which developed in patients with previously not diagnosed CML, is presented in the article. The CML was subsequently diagnosed based on the results of blood analyses and bone marrow aspiration. Treatment strategy consisted of immediate aspiration of blood from the cavernous bodies (19G) followed by the intracavernous injection of phenylephrine solution. After resolving priapism, CML therapy was carried out, which allowed to avoid a recurrence of priapism.


Assuntos
Leucemia Mielogênica Crônica BCR-ABL Positiva/complicações , Fenilefrina/administração & dosagem , Priapismo/terapia , Irrigação Terapêutica , Adulto , Antineoplásicos/uso terapêutico , Medula Óssea/patologia , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Masculino , Pênis/irrigação sanguínea , Fenilefrina/uso terapêutico , Priapismo/etiologia , Recidiva , Resultado do Tratamento
5.
Urologiia ; (5): 119-123, 2019 Dec.
Artigo em Russo | MEDLINE | ID: mdl-31808645

RESUMO

A clinical observation of the distal segmental thrombosis of the left corpus cavernosum is presented in the article. Efficient treatment was based on the results of contrast MRI, and timely application of long-term doses of antithrombotic drugs was done. It is allowed to avoid short-term formation of such a complication as cavernous fibrosis.


Assuntos
Fibrinolíticos/uso terapêutico , Pênis/diagnóstico por imagem , Priapismo , Trombose/tratamento farmacológico , Humanos , Imagem por Ressonância Magnética , Masculino , Pênis/irrigação sanguínea , Priapismo/etiologia , Trombose/diagnóstico por imagem , Resultado do Tratamento
6.
BMJ Case Rep ; 12(7)2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31266754

RESUMO

An 81-year-old man presented to medical services with pelvic pain and evolving urinary retention over 3 months. The patient was found to have a tense glans and penile shaft with surrounding induration consistent with malignant priapism. The extent of the induration included the suprapubic region, scrotum, left iliac region and left flank. A CT scan demonstrated an enhancing, pedunculated lesion arising from the anterior bladder wall measuring 30×31×20 mm. There were multiple enlarged left inguinal lymph nodes. Core biopsies of the subcutaneous tissue on the anterior abdominal wall demonstrated plasmacytoid urothelial carcinoma. The majority of patients with plasmacytoid variant of transitional cell carcinoma will present with >stage 3 bladder disease.


Assuntos
Carcinoma de Células de Transição/diagnóstico por imagem , Carcinoma de Células de Transição/patologia , Neoplasias Penianas/secundário , Priapismo/diagnóstico por imagem , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/patologia , Idoso de 80 Anos ou mais , Biópsia , Carcinoma de Células de Transição/complicações , Humanos , Masculino , Priapismo/etiologia , Tomografia Computadorizada por Raios X/métodos , Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/complicações
7.
Radiol Med ; 124(12): 1270-1280, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31302847

RESUMO

In an emergency department, penile traumas are uncommon and a prompt diagnosis is necessary. Penile injury may result from penetrating and non-penetrating trauma. Non-penetrating injuries can produce cavernosal hematomas or fractures: if not treated promptly, these lesions can result in fibrosis or erectile dysfunction. Penile traumatic lesions need a clinical approach first, but a radiological study is often required: ultrasonography with color and spectral Doppler study is usually the first approach. In some cases, magnetic resonance imaging may be performed to better recognize even small discontinuity of the tunica albuginea. Radiologists have to be aware of the various radiological patterns of penile traumatic lesions, in order to establish a prompt and correct diagnosis.


Assuntos
Pênis/lesões , Ferimentos não Penetrantes/diagnóstico por imagem , Ferimentos Penetrantes/diagnóstico por imagem , Cicatriz/etiologia , Serviço Hospitalar de Emergência , Disfunção Erétil/etiologia , Fibrose/etiologia , Hematoma/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Ereção Peniana , Pênis/anatomia & histologia , Priapismo/etiologia , Ruptura/diagnóstico por imagem , Ruptura/etiologia , Ultrassonografia Doppler em Cores , Uretra/diagnóstico por imagem , Uretra/lesões , Ferimentos não Penetrantes/complicações , Ferimentos Penetrantes/complicações
8.
BMJ Case Rep ; 12(4)2019 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-30988105

RESUMO

Priapism is a relatively uncommon clinical presentation. The well-recognised causes are sickle cell anaemia and the use of medications, such as vasoactive erectile agents. Infrequently, it could be the result of lumbar spinal stenosis. The authors reported an elderly man with 1-year history of isolated intermittent priapism aggravated by walking. MRI showed lumbosacral spondylosis with severe stenosis at the level of L4-L5. Total laminectomy of L4 and L5 was done, resulting in a rapid and complete resolution of symptom without recurrence during the follow-up time of 10 years.


Assuntos
Laminectomia , Vértebras Lombares/diagnóstico por imagem , Priapismo/fisiopatologia , Recuperação de Função Fisiológica/fisiologia , Estenose Espinal/diagnóstico por imagem , Idoso , Humanos , Vértebras Lombares/fisiopatologia , Imagem por Ressonância Magnética , Masculino , Priapismo/diagnóstico por imagem , Priapismo/etiologia , Priapismo/cirurgia , Estenose Espinal/fisiopatologia , Estenose Espinal/cirurgia , Resultado do Tratamento , Caminhada
9.
J Coll Physicians Surg Pak ; 29(1): 78-80, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30630577

RESUMO

Chronic myeloid leukemia (CML) is a chronic myeloproliferative disorder that usually presents with high white blood cell counts and massive splenomegaly. Priapism is a rare manifestation of CML and is mostly due to hyperleukocytosis. Its debut appearance as a sign of hematological dyscrasia is a rare event. Priapism occurring in a setting of any leukemia is both a medical and a urological emergency that requires immediate local therapy, symptomatic treatment, cytoreductive therapy and early initiation of targeted therapy. This case report describes priapism as an unusual presentation of CML and its importance in the work-up and management of patients presenting with priapism.


Assuntos
Leucemia Mielogênica Crônica BCR-ABL Positiva/complicações , Priapismo/etiologia , Antineoplásicos/uso terapêutico , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Priapismo/cirurgia , Resultado do Tratamento
10.
Am J Emerg Med ; 37(4): 796.e3-796.e4, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30660341

RESUMO

Erector spinae plane block (ESPB) is a novel block where local anesthetic is deposited between the erector spinae muscle and the underlying transverse process. Safety of this technique is emphasized in the majority of reports, but with a continued increase of its use, the number of related complications and side effects is likely to expand. We report the case of a patient treated with ESPB for a complex regional pain syndrome, complicated by the development of a priapism.


Assuntos
Síndromes da Dor Regional Complexa/tratamento farmacológico , Bloqueio Nervoso/efeitos adversos , Músculos Paraespinais/inervação , Priapismo/etiologia , Adulto , Anestésicos Locais/administração & dosagem , Humanos , Masculino , Bloqueio Nervoso/métodos , Músculos Paraespinais/diagnóstico por imagem , Ultrassonografia de Intervenção
13.
Cir Pediatr ; 31(4): 200-203, 2018 Oct 17.
Artigo em Espanhol | MEDLINE | ID: mdl-30371034

RESUMO

INTRODUCTION: High-flow priapism is infrequent in pediatric patients. It is mostly secondary to perineal trauma resulting in laceration of a penile artery and the formation of an arterio-cavernous fistula. It does not constitute a medical emergency in itself, and allows conservative management awaiting spontaneous resolution. CLINICAL CASE: A six-year-old boy with painless persistent erection preceded by perineal trauma. Ultrasound imaging confirmed the clinical suspicion of high flow priapism secondary to arterio-cavernous fistula. After adopting a conservative approach, the patient presented progressive detumescence, as well as ultrasound resolution one month after the episode. COMMENTS: In high-flow priapism, venous drainage of the penis is preserved. The classical approach in adults is based on therapeutic angiography, which presents greater technical complexity and the risk of iatrogenic hypoxia in pediatric patients.


Assuntos
Tratamento Conservador/métodos , Fístula/complicações , Períneo/lesões , Priapismo/terapia , Criança , Humanos , Masculino , Pênis/irrigação sanguínea , Pênis/diagnóstico por imagem , Priapismo/diagnóstico por imagem , Priapismo/etiologia , Ultrassonografia
14.
Arch Ital Urol Androl ; 90(3): 218-219, 2018 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-30362692

RESUMO

INTRODUCTION: High-flow priapism is a rare condition in children, usually due to a perineal trauma. MATERIALS AND METHODS: We present a case of traumatic highflow priapism investigated by Doppler ultrasound and managed by angiography and selective embolization of a branch of the internal pudendal artery. RESULTS: A 13-year-old gymnast underwent perineal trauma during training and developed a high-flow priapism. The first ultrasound (immediately after the trauma) showed the presence of an inhomogeneous area of 3 x 2 cm associated with an anechoic vascularized area (pseudoaneurysm) in the right corpus cavernosum. On the left side there was a similar finding, but of smaller size. After 3 weeks the pseudoaneurysm on the left was completely obliterated while the right one was still present. Angiography and superselective catheterization of a branch of the left pudendal artery and its embolization with microspheres and with metal microcoils were performed. After the procedure, ultrasound showed that the right pseudoaneurysm was completely obliterated and there were no more branches reaching it. The cavernous arteries were both pervious. CONCLUSIONS: Selective arterial embolization is a safe treatment that can also be used in pediatric patients.


Assuntos
Embolização Terapêutica/métodos , Ginástica/lesões , Períneo/lesões , Priapismo/terapia , Adolescente , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/terapia , Angiografia/métodos , Humanos , Masculino , Priapismo/etiologia , Resultado do Tratamento , Ultrassonografia Doppler/métodos
15.
J Pak Med Assoc ; 68(6): 942-944, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30323364

RESUMO

Priapism is known as a very rare complication of leukaemia. We report a 16-years boy who presented with the persistent painful erection of the penis for eleven days. He had aspiration without achieving sustained detumescence. The patient underwent an emergency irrigation and decompression of priapism by a consultant urologist. During the hospital stay blood morphology, bone marrow aspiration and BCR-ABL were done to confirm the diagnosis of chronic myeloid leukaemia. Our report thus explains the relevance of all physicians in the diagnosis and management of patients with priapism.


Assuntos
Leucemia Mielogênica Crônica BCR-ABL Positiva/diagnóstico , Priapismo/cirurgia , Adolescente , Medula Óssea/patologia , Descompressão Cirúrgica , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/complicações , Leucemia Mielogênica Crônica BCR-ABL Positiva/patologia , Masculino , Priapismo/etiologia , Procedimentos Cirúrgicos Urológicos Masculinos
16.
Prog Urol ; 28(14): 772-776, 2018 Nov.
Artigo em Francês | MEDLINE | ID: mdl-30201552

RESUMO

OBJECTIVE: Our aim was to present a synthesis on the diagnosis and treatment of priapism. METHODS: For this purpose, a literature search was performed through PubMed to analyze literature reviews and guidelines regarding priapism. RESULTS: Priapism is an erection that persists more than 4hours. There are 3 types of priapism: ischemic priapism, non-ischemic priapism and recurrent (stuttering) priapism. Ischemic priapism, often idiopathic, is the most frequent. When diagnosed, an urgent management is required to limit erectile dysfunction. Sickle-cell patients are prone to have ischemic and stuttering priapism. Non-ischemic priapism usually occurs after perineal trauma. Priapism management depends on the type of priapism. Medical treatment (corporal aspiration and injection of sympathomimetics) then if failed, surgery are indicated for ischemic priapism. The persistence of a non-ischemic priapism most likely requires a radiologic embolization. CONCLUSION: Priapism is a condition that often requires emergency treatment to spare erectile function. It appears crucial to know this condition and its management.


Assuntos
Ereção Peniana/fisiologia , Priapismo/diagnóstico , Humanos , Masculino , Priapismo/etiologia , Priapismo/terapia
17.
Zhonghua Nan Ke Xue ; 24(8): 675-680, 2018 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-30173423

RESUMO

Priapism is a rare pathological penile erection, and there are some inadequacies in its definition, classification, diagnosis, and therapeutic strategies. In this article, we sum up our years of experience with priapism and put forward some new views and ideas about its definition, classification, pathophysiologic process, pathological change, diagnostic essentials, therapeutic measures, indications of successful treatment, and post-therapeutic rehabilitation of erectile function. We also describe the clinical features, diagnosis and treatment of some special types of priapism, such as intermittent seizure, sleep-related painful erection, and tumor-related priapism, hoping to help urologists and andrologists in the further understanding and management of priapism.


Assuntos
Ereção Peniana , Priapismo , Humanos , Masculino , Priapismo/classificação , Priapismo/diagnóstico , Priapismo/etiologia , Priapismo/terapia
18.
Zhonghua Nan Ke Xue ; 24(1): 59-61, 2018.
Artigo em Chinês | MEDLINE | ID: mdl-30157362

RESUMO

Objective: To introduce our experience in the treatment of arterial priapism by superselective embolization. METHODS: This study included 5 cases of perineal trauma-induced arterial erectile dysfunction treated in our departmentbetween February 2011 and May 2015, all failingpreviously to respond to 3 weeks of conservative treatment. The patients were aged 25-47 (mean 35) years, with the onset of arterial priapism at 2-5 days after trauma, and all subjected to physical examination, blood gas analysis, color Doppler ultrasonography of the corpora cavernosum, and IIEF-5 scoring. All the patients underwent superselective embolization, followed by local pressing and cold compression, and IIEF-5 scores were obtained again at 6 and 12 months postoperatively. RESULTS: All the patients had normal erectile functionbefore trauma, with a mean IIEF-5 scoreof 24.60 ± 0.55. Complete detumescenceor painless flaccidity of the penis was achieved in 1 case immediately after surgery and in the other 4 after 3-17 days of postoperative conservative treatment. None of the patients needed a second embolization and no relapse was found during a mean follow-upof 27.2 (13-48)months. The IIEF-5 scores obtained at 6 (24.00 ± 1.02) and 12 months (24.20 ± 0.82) were normal, with no statistically significant differencesfrom that before trauma. CONCLUSIONS: Selective embolization is a safe and effective option for the treatment of arterial priapism. In case of no immediate painless flaccidity of the penis after surgery, conservative treatment can be extended rather than a second operation.


Assuntos
Embolização Terapêutica/métodos , Pênis/irrigação sanguínea , Priapismo/terapia , Adulto , Artérias , Disfunção Erétil/etiologia , Disfunção Erétil/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Períneo , Período Pós-Operatório , Priapismo/etiologia , Recidiva , Ultrassonografia Doppler em Cores
19.
Ned Tijdschr Geneeskd ; 1622018 Jun 15.
Artigo em Holandês | MEDLINE | ID: mdl-30040312

RESUMO

The term priapism describes erections of >4 hours that arise in the absence of or last well beyond sexual stimulation. Ischaemic priapism is the most common form and treatment success is strongly dependent on the duration of priapism. The aetiology is widely variable as a result of which several specialisms can be confronted with this condition. Over the past few years, urologists increasingly have to deal with patients who do not suffer from erectile dysfunction, but nevertheless use intracavernous injections with priapism as a result. These men are often reluctant to see a doctor due to shame and ignorance, which often leads to delayed treatment. According to current guidelines, early prosthesis implantation is recommended if the priapism lasted >36 hours. Treatment of stuttering priapism should be focused on prevention of subsequent episodes. Non-ischaemic priapism generally follows a mild course and can initially be approached conservatively.


Assuntos
Tratamento Conservador/métodos , Serviços Médicos de Emergência , Priapismo , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Humanos , Masculino , Seleção de Pacientes , Priapismo/diagnóstico , Priapismo/etiologia , Priapismo/terapia , Tempo para o Tratamento
20.
Ital J Pediatr ; 44(1): 85, 2018 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-30053817

RESUMO

Neonatal priapism is a rare condition with only 26 described cases in literature since 1879. It is defined as a persistent penile erection occurring in the first 28 days of life, lasting at least 4 h that usually happens in the first days (from 2 to 12 days). It is a very different condition compared to the adult one because in newborns it is a relatively benign phenomenon. As a result of this paucity of described cases, classification and management are not well known by most of neonatologists and currently there are no established guidelines for its management. Most cases are idiopathic but other aetiologies are possible (polycythemia, blood transfusion and drugs). We describe our only case, which occurred during hypothermia therapy and review the literature to clarify the best choice in management of this rare entity.


Assuntos
Hipotermia Induzida/efeitos adversos , Hipóxia-Isquemia Encefálica/terapia , Priapismo/etiologia , Humanos , Recém-Nascido , Masculino
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