Penile prosthesis implant in the special populations: diabetics, neurogenic conditions, fibrotic cases, concurrent urinary continence surgery, and salvage implants / 亚洲男科学杂志(英文版)

Penile prosthesis implant (PPI) remains an effective and safe treatment option for men with erectile dysfunction (ED). However, PPI surgery can be associated with a higher risk of complications in certain populations. This article provides a critical review of relevant publications pertaining to PPI in men with diabetes, significant corporal fibrosis, spinal cord injury, concurrent continence surgery, and complex salvage cases. The discussion of each category of special populations includes a brief review of the surgical challenges and a practical action-based set of recommendations. While specific patient populations posed considerable challenges in PPI surgery, strict pre- and postoperative management coupled with safe surgical practice is a prerequisite to achieving excellent clinical outcomes and high patient satisfaction rate.

Priapismo en la drepanocitosis. Diagnóstico y opciones terapéuticas / Priapism in sickle cell disease. Diagnosis and therapeutics options

El priapismo es una complicación de la anemia drepanocítica y se define como una erección prolongada, dolorosa y persistente del pene de más de 4 horas de duración sin estimulación sexual asociada. El 95 por ciento de las crisis de priapismo en estos pacientes es de tipo isquémico o de bajo flujo y constituyen una emergencia médica que, de no diagnosticarse y tratarse adecuadamente, provoca necrosis del tejido y disfunción eréctil. En este trabajo se revisan el diagnóstico y las opciones terapéuticas actuales y futuras de esta grave complicación(AU)

Priapism is a common complication of sickle cell disease and it is characterized by a prolonged, painful and persistent erection of the penis lasting more than 4 hours without associated sexual stimulation. The 95 percent of priapism crisis in these patients is ischemic type and represents a medical emergency that can provoke erectile tissue necrosis and erectile dysfunction if not treated properly. In this paper we reviewed the diagnosisand the current and perspectives therapeutic options of this severe complication(AU)

Reduction Corporoplasty

Objective Here we present the first video demonstration of reduction corporoplasty in the management of phallic disfigurement in a 17 year old man with a history sickle cell disease and priapism. Introduction Surgical management of aneurysmal dilation of the corpora has yet to be defined in the literature. Materials and Methods: We preformed bilateral elliptical incisions over the lateral corpora as management of aneurysmal dilation of the corpora to correct phallic disfigurement. Results The patient tolerated the procedure well and has resolution of his corporal disfigurement. Conclusions Reduction corporoplasty using bilateral lateral elliptical incisions in the management of aneurysmal dilation of the corpora is a safe an feasible operation in the management of phallic disfigurement. .

Prolonged priapism following single dose administration of sildenafil: a rare case report

A case of priapism following the consumption of a single dose of sildenafil is reported, A 25-year-old unmarried healthy man consumed non-prescribed 50 mg sildenafil purchased over the counter. He developed painful priapism 30 min after the drug intake that had lasted for 4 days [96 h] when he sought medical advice as an emergency. The corpus spongiosum and glans was soft and the corpus cavernosa was rigid. Winter's shunt was done. Fifteen milliliters of dark blood was aspirated with 16 G needle. Detumescence was achieved within 30 min. He was discharged after 12 h. On one month follow-up, he had normal morning erections. A genetic basis with cross-reactivity of PDE-3 in addition to PDE-5 resulting in a cumulative erection effect may be possible elucidation for this unwanted side effect in rare cases. However, the number of cases reported with this side effect is still too less to draw further conclusions

Citalopram induced priapism-the hard fact

Priapism is a persistent, usually painful, erection that lasts for more than four hours and occurs without sexual stimulation. The condition develops when blood in the penis becomes trapped and is unable to drain. This condition appears to affect only the corpora cavernosa, while the corpora spongiosum of the glans penis and surrounding urethra remain flaccid. Priapism may be a urologic emergency that is associated with the development of irreversible erectile function problems. Therefore, immediate and aggressive management may be necessary. If the condition is not treated immediately, it can lead to scarring and permanent erectile dysfunction Citalopram is a relatively new selective serotonin reuptake inhibitor [SSRI] that is becoming widely administered for the treatment of depression. Selective serotonin reuptake inhibitors generally are associated with mild adverse sexual side effects; however, more serious reactions may occur. Although selective serotonin reuptake inhibitors [SSRIs] can induce sexual side effects, such as diminished libido, delayed orgasm, anorgasmia, ejaculatory disturbances, and erectile dysfunction, priapism occurs rarely [1]. We present a case report of 45 years old gentleman who presented in A and E of Gloucester Royal Infirmary, Gloucestershire UK, with priapism of 4 days' duration

Puente safenocavernoso como tratamiento del priapismo postraumático. Informe de un caso / Sapheno-cavernous by-pass as a treatment for post-traumatic priapism. Case report

Priapismo es una persistente erección en la ausencia de deseo sexual o estimulación y una de sus causas es el trauma. Se presenta el caso de un joven de 24 años de edad que sufre de traumatismo cerrado en región perineal presentando priapismo doloroso. El ultrasonido Doppler color corrobora el diagnóstico de priapismo de flujo alto descartándose fístula arteriovenosa. Se realiza inicialmente manejo farmacológico con la inyección intracarvenosa de fenilefrina sin éxito, por lo que se realiza exploración quirúrgica del cuerpo del pene y realizándose derivación safenocavernosa con éxito, cursando con complicación postoperatoria de edema prepucial que se resuelve a las 4 semanas, el paciente presenta a un mes de la cirugía erección nocturna y estimulación sexual normal. La fisiopatología, dignóstico y tratamiento del priapismo postraumatico es revisado en la literatura y discutido

Le traitement du priapisme par le shunt caverno-spongieux selon la technique de Al-Ghorab: a propos de 5 cas traites a la Clinique Chirurgicale des Armees de Pointe-Noire (Congo)

De 1985 a 1988 nous avons traite 5 cas de priapisme par la realisation d'une fistule au Shunt caverno-spongieux selon la technique tres simple de Al-Ghorab. Il s'agissait d'un cas de priapisme traumatique chez un coureur cycliste et de quatre cas de priapisme drepanocytaire dont un heterozygote AS et 3 homozygotes SS; apres apres echec de traitement par transfusion et alcalinisation. Le delai optimal d'intumescence pre-operatoire a ete de 5 jours et la virilite post-operatoire a ete un succes pour les quatre patients revus; car le cinquieme patient a ete perdu de vue

Frecuencia, manejo y evolucion del priapismo en pacientes que acuden al Hospital "Dr. Francisco Moscoso Puello" / Frecuency, management and progression of priapism in patients at Hospital Dr. Francisco Moscoso Puello

Con el objetivo de conocer menejo, evolucion y frecuencia de los esquemas de tratamientos en pacientes con priapismo previamente diagnosticado en el Hospital Francisco Moscoso Puello revisamos 14 casos durante el 1983-1988; encontrandonos que el 78 por ciento asistio al hospital antes de las 72 horas de iniciado el cuadro, usandose tratamiento medico al 92.8 por ciento y persistiendo el 100 por ciento . Se aplico tratamiento quirurgico al 92.8 por ciento (tecnica Chester-Winter) presentado resolucion del cuadro 53.8 por ciento y cursando con persistencia 46.2 por ciento y de estos 23 por ciento sufrio impotencia sexual. Se concluye senalando que el tratamiento medico usado es inefectivo por lo que recomendamos ensayar medidas alternativas como el uso de neostigmina, ketamina y diazepan

Dos simples técnicas quirúrgicas para el tratamiento del priapismo / Two simple surgical technics for the treatment of priapism

Se presentan dos métodos quirúrgicos de tratamiento del priapismo, que tienen en común la creación de una fístula entre el glande y los cuerpos cavernosos. Ambas técnicas demuestran ser simples y efectivas en el manejo de esta entidad

Tratamiento quirúrgico del priapismo / Surgical treatment of priapism

Se analizan los resultados del tratamiento quirúrgico en 29 pacientes portadores de priapismo. La técnica quirúrgica más empleada fué la anastomosis safeno-cavernosa, seguida de la anastomosis caverno-esponjosa y del shunt glande-cavernoso. No hubo complicaciones quirúrgicas con ninguno de los procedimientos empleados. La evolución alejada demuestra una tasa de impotencia cercana al 50%, todos los pacientes con duración promedio del priapismo mayor a 48 horas