priapism

Question 1

patient 56 yr M , presented to ED with 7 hr of priapism without arousal ,what are the complications if this condition being untreated ?

Answer 1

1- sexual dysfunction

2-Penile ischemia

Question 2

What is the role of cavernosal blood gas analysis in determining the cause of priapism ?

Answer 2

Ischemic ( low flow ) - surgical treatment 
Non ischemic ( high flow ) - conservative treatment

Question 3

causes of ischemic ( low flow ) priapism

Answer 3

1- clotting disorder
2- ED treatment
3- medication ( viagra , sildenafil , CCB , chlorpromazine ) , caverject , alprostadil
4- Sickle cell anaemia

Question 4

Causes of high flow priapism

Answer 4

1- spinal trauma

2- fistula

Question 5

Investigations used in priapism

Answer 5

1- USS ( to see the blood flow and vessles size )

2- FBE ( blood dyscrasias ) sickle cell

Question 6

Treatment of low flow priapism

Answer 6

1- Parenteral analgesia
2-20 G needle aspirate of 20-30 ml from each corpora
3- inject 1-2 ml of phenylepherine 1mg/10 ml , repeat up to 4 times .

Question 7

treatment of non ischemic priapism

Answer 7

1- ice packs and compression

Question 8

Penile block , procedure ?

Answer 8

Inject superior to base of penis

aiming for 45 degrees , aiming towards each SIJ