Are There Clinical Factors Relating to Penile Pain associated with Intracavernous Injection of Prostaglandin E1 in Patients with Erectile Dysfunction? / 대한비뇨기과학회지

PURPOSE: We performed this study to identify the factors relating to penile pain after intracavernosal injection of prostaglandin E1. MATERIALS AND METHODS: We studied 116 patients with erectile dysfunction, who were evaluated by color duplex ultrasonography after intracavernosal injection of prostaglandin E1. Flow parameters and several clinical factors including age, the presence of vascular risk factors, and the severity or duration of erectile dysfunction were compared according to the degree of pain after intracavernosal injection. RESULTS: Most of patients (79% of total) receiving intracavernosal injections felt penile pain, and severe pain interfering with sexual activity was reported by 27% of patients. We could not find any clinical factor that correlated with the pain, nor was there a consistent association of pain with any particular hemodynamic parameter of the penis (p>0.05). CONCLUSIONS: The pain developing after intracavernosal injection of prostaglandin E1 might be related to individual tissue or receptor properties of the penile cavernous tissue.

A Case of High-Flow Priapism That was Initially Presented as Low-Flow Priapistic State / 대한남성과학회지

Two forms of priapism are known. The more common type, low-flow priapism, presents as a prolonged painful erection and is characterized by ischemia and a disordered veno-occlusive mechanism. The less common form, high-flow priapism, is characterized by absence of pain and ischemia and unregulated blood inflow from the artery to the cavernosal sinuses. Prompt relief of priapism is essential to prevent ischemia and fibrosis of the corpora with resultant impotence. According to the type of priapism, the therapeutic approach is different. We report a case of idiopathic priapism that was initially identified as low-flow priapism. However, during treatment, it was confirmed as high-flow priapism by the finding of an arteriocavernosal fistula on arteriography, and the abnormal erection subsided after arterial embolization. On arteriography, there was an aberrant artery from the right common penile artery, and we were able to seen an arterial blush from the aberrent artery to the right cavernosal base.