Literature DB >> 26856282

Ischemic priapism in South-East Nigeria: Presentation, management challenges, and aftermath issues.

F O Ugwumba1, H C Ekwedigwe, K N Echetabu, A D Okoh, I Nnabugwu, E S Ugwuidu.   

Abstract

CONTEXT: Ischemic priapism is the more common variety of priapism and often presents late. Outcome is largely dependent on the duration of ischemia. AIMS: To determine the etiology, presentation, management, and outcome of ischemic priapism. SETTINGS AND
DESIGN: Retrospective analysis of consecutive cases presenting to three hospitals offering specialist urological services in South-East Nigeria from January 2000 to December 2010. PATIENTS AND METHODS: Fifteen patients were assessed for clinical data and outcome. STATISTICAL ANALYSIS USED: The data were analyzed descriptively and inferentially using Statistical Package for Social Sciences (SPSS version 16, SPSS Inc., Chicago IL, USA) with P < 0.05.
RESULTS: Mean age was 30.5 years (standard deviation [SD] =1.63), range: 14-79 years. Onset to presentation interval ranged from 6 h to 28 days. Eight patients (53.3%) had sickle cell disease (SCD). Four patients (26.7%) had unidentified causes. The 8 SCD patients had stuttering priapism on several occasions previously. Six patients (40%) had taken oral herbal medications as treatment prior to presentation. Initial resuscitative measures were intravenous hydration, aspiration, and irrigation with normal saline in 13 patients. Glanulo-cavernous shunt (Al-Ghorab) was performed in all the patients. Detumescence was immediate in 14 and delayed in 1 patient. Three patients had transient recurrence of tumescence, while one had to be reshunted. Erectile dysfunction (ED) occurred in 7 patients (46.7%). Occurrence of ED increased significantly in patients presenting 24 h after onset of symptoms ([P = 0.032] Fishers exact test). Mean duration of follow-up was 21.9 weeks (SD = 4.1), range: 3-156 weeks.
CONCLUSIONS: Low flow priapism is common in our environment, and approximately half will occur in SCD patients who have had stuttering priapism previously. Timely diagnosis and treatment will reduce the probability of severe ED. In our experience, the Al-Ghorab shunt provides rapid relief. Enlightenment is vital in reducing ischemia time. Emphasis on preventive measures in SCD patients is vital.

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Year:  2016        PMID: 26856282     DOI: 10.4103/1119-3077.175968

Source DB:  PubMed          Journal:  Niger J Clin Pract            Impact factor:   0.968


  4 in total

Review 1.  Surgical and minimally invasive treatment of ischaemic and non-ischaemic priapism: a systematic review by the EAU Sexual and Reproductive Health Guidelines panel.

Authors:  S Minhas; A Salonia; U Milenkovic; A Cocci; R Veeratterapillay; K Dimitropoulos; L Boeri; P Capogrosso; N C Cilesiz; M Gul; G Hatzichristodoulou; V Modgil; G I Russo; T Tharakan; M I Omar; C Bettocchi; J Carvalho; Y Yuhong; G Corona; H Jones; A Kadioglu; J I Martinez-Salamanca; P Verze; E C Serefoglu
Journal:  Int J Impot Res       Date:  2022-09-23       Impact factor: 2.408

2.  Prevalence of priapism in individuals with sickle cell disease and implications on male sexual function.

Authors:  Mateus Andrade Alvaia; Heros Aureliano Antunes da Silva Maia; Alana de Medeiros Nelli; Carina Oliveira Silva Guimarães; Evanilda Souza de Santana Carvalho; José Murillo Bastos Netto; Eduardo de Paula Miranda; Cristiano Mendes Gomes; José de Bessa Júnior
Journal:  Einstein (Sao Paulo)       Date:  2020-04-22

3.  Spectrum of urological emergencies and surgical interventions in a single tertiary health center.

Authors:  Babatunde K Hamza; Muhammed Ahmed; Musliu Adetola Tolani; Mudi Awaisu; Ahmad Tijjani Lawal; Nasir Oyelowo; Ahmad Bello; Hussein Yusuf Maitama
Journal:  Afr J Emerg Med       Date:  2021-02-19

4.  Management of acute sickle cell priapism in an African (Togo) pediatric department includes conservative measures and intracavernous epinephrine which is safe and efficacious.

Authors:  Koffi Mawuse Guedenon; Mawouto Fiawoo; Djatougbe Ayaovi Elie Akolly; Etse Akpako; Balakibawi Esso; Fidèle Comlan Dossou; Adama Dodji Gbadoe
Journal:  EJHaem       Date:  2022-04-26
  4 in total

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