Literature DB >> 31501058

Priapism from Recreational Intracavernosal Injections in a High-Risk Metropolitan Community.

Hanson Zhao1, Carl Berdahl2, Catherine Bresee3, Ariel Moradzadeh1, Justin Houman1, Howard Kim1, Karyn Eilber1, Joshua Pevnick4, Jennifer T Anger5.   

Abstract

INTRODUCTION: Recreational use of intracavernosal injections (ICIs) is a high-risk behavior that involves sharing of these agents by men without physician regulation. AIM: To characterize the etiologies and outcomes of priapism at a Los Angeles metropolitan medical center to better understand patterns of usage of recreational ICIs and the public health implications of such practices.
METHODS: With institutional review board approval, we retrospectively reviewed all cases of priapism presenting to the emergency room of a Los Angeles tertiary medical center from 2010 to 2018. We compared outcomes between patients who presented with priapism after recreational ICI and patients who presented with other etiologies. MAIN OUTCOME MEASURE: We describe patient characteristics, etiologies, and treatments of priapism at our institution.
RESULTS: We identified 169 priapism encounters by 143 unique patients. Recreational ICIs accounted for 82 of the 169 priapism encounters (49%). Patients who used recreational injections were younger than those who presented with other etiologies (43.5 years vs 47.5 years; P = .048) and had delayed presentations (median, 12 hours vs 8 hours; P < .0001). There was no statistical difference across groups in the proportion of patients requiring operative intervention (14.6% of recreational ICI users vs 16.1% of all other patients; P = .23). A total of 36 out of 72 patients who used recreational ICIs (50%) were HIV+. CLINICAL IMPLICATIONS: Our study adds to the relatively sparse literature on priapism outcomes. We identify and describe a high-risk population that uses recreational intracavernosal injections. STRENGTHS &amp; LIMITATIONS: To our knowledge, this is the largest series of priapism encounters. However, the data are retrospective from a single institution, and there is a lack of long-term follow up.
CONCLUSION: A large proportion of priapism visits at our institution were attributed to recreational use of ICIs. This is a high-risk patient population that may not be aware of the risks of recreational ICIs and the consequences of priapism. Further effort should be made to increase public and physician awareness of this harmful practice. Zhao H, Berdahl C, Bresee C, et al. Priapism from Recreational Intracavernosal Injections in a High-Risk Metropolitan Community. J Sex Med 2019;16:1650-1654.
Copyright © 2019. Published by Elsevier Inc.

Entities:  

Keywords:  Erectile Dysfunction; Intracavernosal Injections; Priapism; Recreational Injections; Trimix

Mesh:

Substances:

Year:  2019        PMID: 31501058      PMCID: PMC7416696          DOI: 10.1016/j.jsxm.2019.07.024

Source DB:  PubMed          Journal:  J Sex Med        ISSN: 1743-6095            Impact factor:   3.802


  14 in total

1.  Recreational use of phosphodiesterase type 5 inhibitors by healthy young men.

Authors:  Amado Bechara; Adolfo Casabé; Walter De Bonis; Adrián Helien; María Victoria Bertolino
Journal:  J Sex Med       Date:  2010-08-16       Impact factor: 3.802

Review 2.  Guideline of guidelines: priapism.

Authors:  Asif Muneer; David Ralph
Journal:  BJU Int       Date:  2016-12-29       Impact factor: 5.588

Review 3.  European Association of Urology guidelines on priapism.

Authors:  Andrea Salonia; Ian Eardley; François Giuliano; Dimitrios Hatzichristou; Ignacio Moncada; Yoram Vardi; Eric Wespes; Konstantinos Hatzimouratidis
Journal:  Eur Urol       Date:  2013-11-16       Impact factor: 20.096

Review 4.  Acute management of priapism in men.

Authors:  Yeng K Tay; Daniel Spernat; Kathryn Rzetelski-West; Sree Appu; Chris Love
Journal:  BJU Int       Date:  2012-04       Impact factor: 5.588

5.  Incidence of priapism in the general population.

Authors:  I A Eland; J van der Lei; B H Stricker; M J Sturkenboom
Journal:  Urology       Date:  2001-05       Impact factor: 2.649

6.  Priapism, its incidence and seasonal distribution in Finland.

Authors:  R V Kulmala; T A Lehtonen; T L Tammela
Journal:  Scand J Urol Nephrol       Date:  1995-03

7.  The incidence and management of priapism in Western Australia: a 16 year audit.

Authors:  C M Earle; B G A Stuckey; H L Ching; Z S Wisniewski
Journal:  Int J Impot Res       Date:  2003-08       Impact factor: 2.896

Review 8.  Priapism: pathogenesis, epidemiology, and management.

Authors:  Gregory A Broderick; Ates Kadioglu; Trinity J Bivalacqua; Hussein Ghanem; Ajay Nehra; Rany Shamloul
Journal:  J Sex Med       Date:  2010-01       Impact factor: 3.802

9.  A review of outcomes of an intracavernosal injection therapy programme.

Authors:  Peter G Coombs; Mathias Heck; Patricia Guhring; Joseph Narus; John P Mulhall
Journal:  BJU Int       Date:  2012-05-07       Impact factor: 5.588

10.  Nationwide emergency department visits for priapism in the United States.

Authors:  Daniel M Stein; Andrew S Flum; John Cashy; Lee C Zhao; Kevin T McVary
Journal:  J Sex Med       Date:  2013-07-10       Impact factor: 3.802

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  3 in total

1.  Medications mostly associated with priapism events: assessment of the 2015-2020 Food and Drug Administration (FDA) pharmacovigilance database entries.

Authors:  Nicolò Schifano; Paolo Capogrosso; Luca Boeri; Giuseppe Fallara; Omer Onur Cakir; Fabio Castiglione; Hussain M Alnajjar; Asif Muneer; Federico Deho'; Fabrizio Schifano; Francesco Montorsi; Andrea Salonia
Journal:  Int J Impot Res       Date:  2022-05-21       Impact factor: 2.896

Review 2.  Conservative and medical treatments of non-sickle cell disease-related ischemic priapism: a systematic review by the EAU Sexual and Reproductive Health Panel.

Authors:  Andrea Salonia; Suks Minhas; Paolo Capogrosso; Kostas Dimitropolous; Giorgio Ivan Russo; Tharu Tharakan; Uros Milenkovic; Andrea Cocci; Luca Boeri; Murat Gül; Carlo Bettocchi; Joana Carvalho; Arif Kalkanlı; Giovanni Corona; Georgios Hatzichristodoulou; Hugh T Jones; Ates Kadioglu; Juan Ignacio Martinez-Salamanca; Vaibhav Modgil; Ege Can Serefoglu; Paolo Verze
Journal:  Int J Impot Res       Date:  2022-08-22       Impact factor: 2.408

3.  Risk Factors for Surgical Shunting in a Large Cohort With Ischemic Priapism.

Authors:  Hanson Zhao; Kai Dallas; John Masterson; Eric Lo; Justin Houman; Carl Berdahl; Joshua Pevnick; Jennifer T Anger
Journal:  J Sex Med       Date:  2020-11-15       Impact factor: 3.802

  3 in total

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