Priapism - Urological emergency

madman

Super Moderator

In this Series, each topic will be covered as a fast shots for the most important points.

In this video we will review the priapism as an urological emergency. You can use the vidoe to revise before the exam, review before assesing patients and as a start before reading the topic.

Screenshot (26893).png
 


Pay close attention.

29:10-32:41 (ICIs potential side effects/risks)

*bruising/swelling (uncommon) - if injection technique is done well

*scarring (relatively uncommon) - may relate to how frequently a man injects and may also relate to just different men having tendencies to develop scarring but it may still be anywhere of <5% at most may be in the 1-2% range develop a kind of thickening effect may be some scarring effects in the penis that can occur

*priapism (largely preventable) - with counseling, demonstrations in the office, proper dosing, patients need to be educated well
 

*Based on our extensive review of animal models and clinical reports of ischemic priapism, understanding that many clinical papers used secondary references and espoused concepts out of the dogma, rather than scientific evidence or fact, we believe that a prudent clinician will initiate the reversal of ischemic priapism as early as possible, around the 4-hour mark. The important question that remains largely unanswered to this day, is when does the onset of nonreversible injury first begin in most cases of ischemic priapism? While there does not exist clear evidence in the medical literature to define that timepoint precisely, based on our review of the literature, we believe it is beyond 6 hours and may extend to 12 hours in some men. (Table 1, 2, 3)
 

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Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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